Compositions for the treatment and prevention of arterial thrombosis and use of an inhibitor of factor Xa alone and/or in combination with an anti-platelet aggregation agent

ABSTRACT

The invention relates to the use of direct or indirect selective inhibitors of factor Xa acting via antithrombin III, alone or in combination with one or more compounds with anti-platelet aggregation activity, for the preparation of medicines intended to prevent and to treat thromboembolic arterial diseases.  
     The subject of the invention is also pharmaceutical compositions containing one or more direct or indirect selective inhibitors of factor Xa which act via antithrombin III in combination with one or more compounds with anti-platelet aggregation activity, and optionally one or more pharmaceutically acceptable vehicles.

[0001] The subject of the present invention is the use of direct or indirect selective inhibitors of factor Xa which act via antithrombin III, alone and/or in combination with a compound with anti-platelet aggregation activity, for their activity in arterial thromboembolic diseases.

[0002] The pharmaceutical compositions containing the combination of antithrombotic and anti-platelet aggregation active ingredients are also included in the invention. The active ingredients constituting the combination are present in the free state or in the form of one of their pharmaceutically acceptable salts.

[0003] During the last decade, a lot of attention has been given to studying the role played by platelets in the development of diseases associated with atherosclerosis (myocardial infarction, angina, cerebral vascular accident, arterial diseases of the lower limbs and the like). Moreover, the well-established role of the blood clotting process in arterial thrombosis has allowed the development of numerous medicines which inhibit various clotting enzymes. The discovery of the essential role of thrombin and factor Xa in the thrombotic process has led to the use of anticoagulants being proposed in the prevention and treatment of arterial thrombosis.

[0004] Among the anticoagulants available, heparin is the preferred medicine in the prevention and treatment of thromboembolic diseases.

[0005] Heparin catalyses, in particular via anti-thrombin III (AT III), the inhibition of two enzymes which are involved in the blood clotting cascade, namely factor Xa and factor IIa (or thrombin). The relative importance of these two activities in the overall activity of heparin remains unknown. Low-molecular-weight heparin (LMWH) preparations contain chains consisting of 4 to 30 monosaccharides which act like heparin on factor Xa and on thrombin but which have the property of being more selective for factor Xa then for thrombin. In spite of this different biological activity profile, low-molecular-weight heparin has an antithrombotic effect as has been demonstrated in studies on animals and on patients suffering from thromboembolic diseases or at risk of forming a thrombus (Hirsch J. et al., J. Thromb. Hemost., 1987, Leuven, Belgium Leuven University Press, 325-348).

[0006] Unlike heparin and the LMWHs, some synthetic oligosaccharides, especially those described in EP 84999, have the property of selectively inhibiting factor Xa via antithrombin III but have no activity on thrombin. These synthetic oligosaccharides which correspond to the antithrombin-binding domain (ABD) or heparin are known and manifest an unthrombotic activity in venous thrombosis. These compounds are described in EP 529715 and EP 621282.

[0007] The efficacy of these oligonucleotides in the prevention of arterial thrombosis was hardly probable because of their inability to inhibit thrombin.

[0008] Indeed, it has long been known in the literature that thrombin plays a key role in arterial thrombosis and this is again confirmed by recent experiments (L. A. Harker, Blood, 1991, 77 1006-1012). Thrombin inhibitors therefore constitute an effective means of preventing or combating this type or thrombosis.

[0009] It has been observed, by comparing the efficacy of heparin to those of direct thrombin inhibitors (direct inhibitor means an inhibitor which inhibits thrombin without requiring AT III), that they are much more effective than heparin for preventing and treating arterial thrombosis (Arteriosclerosis and thrombosis, 1992, 12, 879-885, J. Am. Coll. Cardiol., 1994, 23, 993-1003). The reason for this lack of efficacy is that the heparin/AT III complex cannot, for reasons to do with steric hindrance, inhibit thrombin in a thrombus rich in platelets as is a platelet thrombus.

[0010] The low activity of heparin in contrast to direct inhibitors is therefore linked to its need to use AT III. This explanation is further justified by the recent observation that the direct inhibitors of factor Xa which act without AT III are also effective, in animal models of arterial thrombosis (Circulation, 1991, 84, 1741-1748 Thrombosis Haemost., 1995 74, 640-645).

[0011] A compound which, on the one hand, acts via AT III and, on the other hand, does not inhibit thrombin, would therefore be expected to possess no activity in arterial thrombosis.

[0012] It has now been founds according to the present invention, quite surprisingly, that a direct or indirect selective inhibitor of factor Xa, alone or in combination with a compound with anti-platelet aggregation activity, can be used for their activity in thromboembolic diseases of arterial origin.

[0013] Although it is known to date that the anti-factor Xa agents and the anti-platelet aggregation agents act via two different mechanisms of action, the combination or association of these products for use in arterial thromboembolic diseases has never been studied.

[0014] Accordingly, the subject of the present invention is, according to one of its features, the use of one or more direct or indirect selective inhibitors of factor Xa, alone or in combination with one or more compounds with anti-platelet aggregation activity, for the preparation of medicines intended to prevent and to treat thromboembolic diseases of arterial origin.

[0015] According to the invention, selective inhibitor of factor Xa is understood to mean a compound capable of selectively inhibiting factor Xa via antithrombin (AT III) but not exhibiting significant activity towards thrombin. Preferably, the inhibitor has no activity towards thrombin.

[0016] According to another of its features, the subject of the present invention is also the use of a selective inhibitor of factor Xa which acts via AT III, alone or in combination with a compound with anti-platelet aggregation activity, for the preparation of medicines intended to combat thromboembolic diseases of arterial origin.

[0017] Advantageously, the said direct inhibitors of factor Xa are DX-9065a and its analogues. DX-9065a is in particular described in Thromb. Haemost. 1994, 71, 314-319 and in Drugs Fut. 1995, 206, 564-566 and also in EP 540051. Also advantageously, the indirect inhibitors of factor Xa are synthetic oligosaccharides.

[0018] Among the direct selective inhibitors of factor Xa, DX-9065a is particularly advantageous, and consists of (2S)-2-[4-(((3S)-1-acetimidoyl-3-pyrrolidinyl]oxy]phenyl]-3-(7-amidino-2-naphthyl)-propanoic acid hydrochloride pentahydrate in which the acid has the structure (A)

[0019] and its pharmaceutically acceptable salts, described in particular in Thromb. Haemost. 1994, 71, 314-319 and in Drugs Fut. 1995, 206, 564-566 and also in EP 540051.

[0020] Among the indirect selective inhibitors of factor Xa and advantageously, the synthetic oligosaccharides are pentasaccharides, such as those claimed in patents EP 84999 and U.S. Pat. No. 5,378,829.

[0021] Particularly advantageous pentasaccharides are in particular: methyl O-(2-deoxy-2-sulphoamino-6-O-sulfo-α-D-gluco-pyranosyl)-(1→4)-O-(β-D-glucopyranosyluronic acid)-(1→4)-O-(2-deoxy-2-sulphoamino-3,6-di-O-sulpho-α-D-glucopyranosyl-(1→4)-O-(2-O-sulpho-α-L-idopyranosyl-uronic acid)-(1→4)-2-deoxy-2-sulphoamino-6-O-sulpho-α-D-glucopyranoside whose anion has the structure (B)

[0022] and its pharmaceutically acceptable salts, in particular its decasodium salt, known under its code name SR 90107/ORG 31540, which is described in Chemical Synthesis to Glycoaminoglycans, Supplement to Nature 1991, 350, 30-33 designated hereinafter “PS”;

[0023] methyl O-(3,4-di-O-methyl-2,6-di-O-sulpho-α-D-gluco-pyranosyl)-(1→4)-(3-O-methyl-2-O-sulpho-β-D-glucopyranosyluronic acid)-(1→4)-O-(2,3,6-tri-O-sulpho-α-D-glucopyranosyl)-(1→4)-O-(3-O-methyl-2-O-sulpho-α-L-idopyranosyluronic acid)-(1→4)-2,3,6-tri-O-sulpho-α-D-glucopyranoside known under its code name SANORG 32701, whose anion has the structure (C)

[0024] and its pharmaceutically acceptable salts, in particular its dodecasodium salt, which is described in U.S. Pat. No. 5,378,829;

[0025] methyl O-(2,3,4-tri-O-methyl-6-O-sulpho-α-D-gluco-pyranosyl)-(1→4)-O-(2,3-di-O-methyl-β-D-gluco-pyranosyluronic acid)-(1→4)-O-(2,3,6-tri-O-sulpho-α-D-glucopyranosyl)-(1→4)-O-(2,3-di-O-methyl-α-L-ido-pyranosyluronic acid)-(1→4)-O-2,3,6-tri-O-sulpho-α-D-glucopyranoside, known under its code name SANORG 34006, whose anion has the structure (D)

[0026] and its pharmaceutically acceptable salts, in particular its nonasodium salt, which is also described in U.S. Pat. No. 2,378,829.

[0027] The anti-platelet aggregation agents which can be used in combination or in association with the oligosaccharides may be of various types, such as for example cyclooxygenase inhibitors such as aspirin, or the anti-platelet aggregation agents described in groups I to L below, such as ADP inhibitors such as ticlopidine and clopidogrel, serotonin inhibitors such as ketanserin, ritanserin, sarpogrelate (MCI-9042), SR 46349 or LY-53857, thromboxane inhibitors such as L 670596, SQ 30741, S-145, AA 2414, CV-6504, HN-11500 and ICI-192,605, thromboxane synthetase inhibitors such as ozagrel (OKY-046), Y-20811, RS-5186, FCE-22178, furegrelate (U-63557A) or mixed thromboxane and thromboxane synthetase inhibitors having the combined effects such as ridogrel (or R-68070) and isbogrel (CV-4151), or inhibitors of the GP IIb-IlIa glyco-protein complex such as c7E3 or abciximab, integrelin, SC 52012, TP 9201, RO 44-9883, RO 43-8857, RO 43-5054, MK 0383 or tirofiban, Dup 728, L 703014, SC 54684, SC 58053, GR 144053, Bibu 104, Bibu 129 or thiazole derivatives such as SR 121787A and SR 121566; FK 633, orbofiban; or compounds increasing the intraplatelet cyclic AMP concentration such as PGEI (alprostadil) and prostacycline (epoprostenol), prostaglandin analogues such as iloprost and beraprost, cicaprost, taprostene, ataprost (OP-41483) and ciprostene or dipyridamole or cilostazol.

[0028] The compound of formula (B), preferably in decasodium salt form, is the subject of a preferred use according to the invention and is also the subject of the preferred antithrombotic for the pharmaceutical compositions of the invention as sole active ingredient or in combination with an anti-platelet aggregation agent.

[0029] The anti-platelet aggregation agents are advantageously selected from aspirin or the groups (I) to (L) below:

[0030] I—Ticlopidine and its Analogues of Formula

[0031] in which X₁ represents oxygen or sulphur; R₁ ⁴ represents hydrogen or a phenyl or benzoyl radical optionally substituted with at least one halogen atom or a lower alkyl, lower alkoxy, nitro, amino or sulphonylamino group; R₁ ¹ and R₁ ² each represent at least one atom or group selected from hydrogen, a halogen, or a hydroxyl, lower alkyl, lower alkoxy, nitro or amino group; R₁ ³ represents a hydrogen, a halogen or a hydroxyl, lower alkyl, lower alkoxy, nitro or amino group, and n₁ is zero or an integer from 1 to 15, it being possible for the R₁ ³ symbols to have different meanings in each radical CHR₁ ³ when n₁ is greater than 1, or an addition salt with an acid or a pharmaceutically acceptable quaternary ammonium derivative of this derivative, as described in French patent FR 2,215,948.

[0032] II—Clopidogrel and its Analogues of Formula

[0033] in which Y₂ represents a hydroxyl or a group OR₂ in which R₂ is a straight or branched alkyl group of 1 to 4 carbon atoms, or Y₂ represents a group

[0034] in which R₂ ¹ and R₂ ² are each independently of each other hydrogen or a straight or branched alkyl group of 1 to 4 carbon atoms, or R₂ ¹ and R₂ ² together form, and with the nitrogen atom to which they are attached, a pyrrolidino, morpholino, piperidino or 4-benzyl-piperazino group; and X₂ represents hydrogen, a halogen or an alkyl radical of 1 to 4 carbon atoms; and their addition salts with pharmaceutically acceptable inorganic or organic acids, when Y₂ represents the groups OR₂ or

[0035] or with inorganic bases when Y₂ represents OH, as well as the two enantiomers or their mixture, as described in European patent EP 99802.

[0036] III—Ketanserin and its Analogues of Formula:

[0037] in which:

[0038] Ar₃ is an aryl radical;

[0039] X₃ is a constituent selected from the group consisting of

[0040] in which the said Ra₁ is selected from hydrogen, or a lower alkyl, and q₁ is 2 or 3;

[0041] R₃ is a constituent selected from a hydrogen, a hydroxyl or a lower alkyl;

[0042] Alk₃ is an alkylene having from 1 to 4 carbon atoms; and

[0043] Q₃ is a quinazolinyl radical, its 1-, 2-, 3-, 4-position being linked to the end of the alkylene chain, the said quinazolinyl radical carrying at one or at both of its 2- or 4-positions an oxo or thioxo group, in which the benzene ring of the said quinazolinyl radical is optionally substituted with one to three substituents independently selected from the group consisting of a halogen, a lower alkyl, a lower alkyloxy, a trifluoromethyl, a nitro and a cyano, and in which the pyrimidino ring of the said quinazolinyl radical may be partially or completely saturated, it being possible for the said pyrimidino ring to be optionally substituted with one to three substituents independently selected from the group consisting of a lower alkyl, an aryl and an aryl(lower alkyl);

[0044] in which the said aryl used in the definition of Ar₃ and of Q₃ is a ring selected from the group consisting of a phenyl, a substituted phenyl, a thienyl and a pyridinyl, in which the said substituted phenyl is substituted with 1 to 3 substituents independently selected from the group consisting of a halogen, a lower alkyl, a lower alkyloxy, a trifluoromethyl or an amino, and its pharmaceutically acceptable addition salts, as described in European patent EP 13612.

[0045] IV—Ritanserin or One of its Analogues of Formula:

[0046] in which:

[0047] R₄ is a hydrogen, a hydroxyl or a lower alkyloxy;

[0048] R¹ ₄ is a member of the group consisting of a hydrogen or a lower alkyl:

[0049] Alk₄ is a lower alkylene radical;

[0050] X₄ is selected from the group consisting of —S—, —CH₂— and —C(R₄ ²)═C(R₄ ³)—, the said R₄ ² and R₄ ³ being independently hydrogen or a lower alkyl;

[0051] A₄ is a bivalent radical having the formula —CH₂—CH₂—, —CH₂—CH₂—CH₂— or —C(R⁴ ₄)═C(R⁵ ₄)— in which R⁴ ₄ and R⁵ ₄ are each independently selected from the group consisting of a hydrogen, a halogen, an amino or a lower alkyl; and

[0052] Ar¹ ₄ and Ar² ₄ are independently selected from the group consisting of pyridinyl, thienyl and phenyl, the said groups being optionally substituted with a halogen, a hydroxyl, a lower alkyloxy and a trifluoromethyl, the isomeric stereochemical forms thereof as well as the pharmaceutically acceptable acid addition salts, as described in European patent EP 110435.

[0053] V—Sarpogrelate or One of its Derivatives of Formula:

[0054] in which

[0055] R₅ ¹ is a hydrogen, a halogen, a (C₁-C₅)alkoxy or a (C₂-C₆)dialkylamino;

[0056] R₅ ² is a hydrogen, a halogen or a (C₁-C₅)alkoxy;

[0057] R₅ ³ is a hydrogen, a hydroxyl, an —O—(CH₂)_(n5)—COOH or an —O—CO—(CH₂)1₅-COOH in which n₅ is an integer from 1 to 5 and l₅ is an integer from 1 to 3;

[0058] R₅ ⁴ is a group

[0059] in which R₅ ⁵ and R⁶ ₅ are independently a hydrogen or a (C₁-C₈)alkyl and A₅ is a (C₃-C₅)alkylene or a (C₃-C₅)alkylene substituted with a carboxyl;

[0060] m₅ is an integer from 0 to 5; or one of its pharmaceutically acceptable salts, as described in European patent EP 398326.

[0061] VI—The Oxime Ethers of Propenone of Transgeometry Relative to the Ethylenic Double Bond of Formula:

[0062] in which:

[0063] Ar₆ and Ar′₆ may each independently denote either:

[0064] a) a phenyl group which is unsubstituted or is mono- or polysubstituted with a halogen atom, an alkyl group of 1 to 4 carbon atoms, a nitro group, a hydroxyl group, an alkoxy group of 1 to 4 carbon atoms, an acyloxy group of 1 to 4 carbon atoms, a dimethylamino group, a carboxyalkoxy group in which the alkyl portion contains from 1 to 4 carbon atoms, 9-anthryl or a naphthyl group;

[0065] b) a heteroaromatic group selected from the pyridyl, thienyl and furyl groups;

[0066] R₆ ¹ and R₆ ² each independently denote a hydrogen atom, an alkyl group of 1 to 4 carbon atoms or alternatively R₆ ¹ and R₆ ² constitute with the nitrogen atom to which they are attached a 1-pyrrolidinyl, piperidino, morpholino or 1-piperazinyl group;

[0067] M₆ represents a hydrogen atom, a chlorine or bromine atom, a straight or branched alkyl group of 1 to 6 carbon atoms;

[0068] n₆ represents 2 or 3;

[0069] as well as their salts with inorganic or organic acids and more particularly the compound known under the code name SR 46349 B, as described in EP 373998.

[0070] VII—LY 53857 or One of its Analogues of Formula:

[0071] in which R₇ ¹ is a hydrogen, a (C₁-C₃)alkyl, an allyl or a benzyl, and R₇ ² is a (C₂-C₈)monohydroxyalkyl, a (C₂-C₈)dihydroxyalkyl or a monohydroxycycloalkyl having from 5 to 8 carbon atoms and the salts thereof with pharmaceutically acceptable acids, as described in U.S. Pat. No. 3,580,916.

[0072] VIII—L 670596 and the Derivatives of Tetrahydrocarbazole-1-alkanoic Acids Consisting of the Compounds of Formula:

[0073] 9-o-chlorobenzyl-6,8-difluoro-1,2,3,4-tetrahydrocarbazol-1-yl-acetic acid;

[0074] 9-(2,4-dichlorobenzyl,)-6,8-difluoro-1,2,3,4-tetrahydrocarbazol-1-yl-acetic acid;

[0075] 9-p-methylthiobenzyl-6,8-difluoro-1,2,3,4-tetrahydrocarbazol-1-yl-acetic acid;

[0076] 9-p-methylsuphinylbenzyl-6,8-difluoro-1,2,3,4-tetrahydrocarbazol-1-yl-acetic acid;

[0077] 9-p-methylsulphonylbenzyl-6,8-difluoro-1,2,3,4-tetrahydrocarbazol-1-yl-acetic acid;

[0078] (−)9-p-methylsulphonylbenzyl-6,8-difluoro-1,2,3,4-tetrahydrocarbazol-1-yl-acetic acid;

[0079] (+)9-p-methylsulphonylbenzyl-6,8-difluoro-1,2,3,4-tetrahydrocarbazol-1-yl-acetic acid;

[0080] 9-p-trifluoromethylbenzyl-6t8-difluoro-1,2,3,4-tetrahydrocarbazol-1-yl-acetic acid;

[0081] 9-p-fluorobenzyl-6,8-difluoro-1,2,3,4-tetrahydrocarbazol-1-yl-acetic acid;

[0082] 9-m-chlorobenzyl-6,8-difluoro-1,2,3,4-tetrahydrocarbazol-1-yl-acetic acid;

[0083] 9-p-carbomethoxybenzyl-6,8-difluoro-1,2,3,4-tatrahydrocarbazol-1-yl-acetic acid;

[0084] 9-p-dimethylcarbamoyl-6,8-difluoro-1,2,3,4-tetrahydrocarbazol-1-yl-acetic acid;

[0085] 9-p-acetylbenzyl-6,8-difluoro-1,2,3,4-tetrahydrocarbazol-1-yl-acetic acid;

[0086] 9-p-dimethylaminosulphonylbenzyl-6,8-difluoro-1,2,3,4-tetrahydrocarbazol-1-yl-acetic acid;

[0087] 9-p-acetamidobenzyl-6,8-difluoro-1,2,3,4-tetrahydrocarbazol-1-yl-acetic acid;

[0088] 9-p-methylsulphonamidobenzyl-6,8-difluoro-1,2,3,4-tetrahydrocarbazol-1-yl-acetic acid;

[0089] 9-p-methylureidobenzyl-6,8-difluoro-1,2,3,4-tetrahydrocazbazol-1-yl-acetic acid and

[0090] 9-p-methoxybenzyl-6,8-difluoro-1,2 3,4-tetrahydrocarbazol-1-yl-acetic acid;

[0091] which are described in EP 300 676.

[0092] IX—SQ 30741 as Well as the Compounds of Structure:

[0093] in which mg is an integer from 0 to 4; A₉ is a group —CH═CH— or —CH₂—CH₂—; n₉ is an integer from 1 to 5; X₉ is a halogen, an alkanoyloxy or a hydroxyl; p₉ is 1 to 4; R₉ ¹ is H or a lower alkyl; q₉ is an integer from 1 to 12; R₉ ² is H or a lower alkyl; and R₉ ³ is H, a lower alkyl, a lower alkenyl containing from 2 to 12 carbon atoms, an aryl, an arylalkyl, a lower alkoxy, an aryloxy, an amino, an alkylamino or an arylamino; in which the lower alkyl or the alkyl alone or as a constituent of another group contains from 2 to 12 carbon atoms and is unsubstituted or is substituted with a halogen, a CF₃, an alkoxy, an aryl, an arylalkyl, a haloaryl, a cycloalkyl, an alkylcycloalkyl, a hydroxyl, an alkylamino, an alkanoylamino, an arylcarbonyl amino, a nitro, a cyano, a mercapto or an alkylthio; the aryl alone or as a constituent of another group contains from 6 to 10 carbon atoms on the cyclic portion and is unsubstituted or is substituted with one or two lower alkyls, 1 or 2 halogens, 1 or 2 hydroxyl groups, 1 or 2 lower alkoxy groups, 1 or 2 alkylamino groups, 1 or 2 alkanoylamino groups, 1 or 2 arylcarbonylamino groups, 1 or 2 amino groups, 1 or 2 nitro groups, 1 or 2 cyano groups, 1 or 2 mercapto groups and/or 1 or 2 alkylthio groups; and the cycloalkyl alone or as a constituent of another group contains from 3 to 12 carbon atoms, is unsubstituted or is substituted with 1 or 2 halogens, 1 or 2 lower alkyl groups, 1 or 2 lower alkoxy groups, 1 or 2 hydroxyl groups, 1 or 2 alkylamino groups, 1 or 2 alkanoylamino groups, 1 or 2 arylcarbonylamino groups, 1 or 2 amino groups, 1 or 2 nitro groups, 1 or 2 cyano groups, 1 or 2 mercapto groups and/or 1 or 2 alkylthio groups; (CH₂)_(m9), (CH₂)_(n9) and (CH₂)p₉ may be substituted with 1 or 2 lower alkyl and/or 1 or 2 halogen substituents; and (CH₂)q₉ may be substituted with one or more halogen, hydroxyl, alkoxy, amino, alkylamino arylamino, carbamoyl, thiocarbamoyl, mercapto, alkylthio, arylthio, cyano or nitro groups; as well as all its stereoisomers, as described in U.S. Pat. No. 4,638,012.

[0094] X—S-145 and the Compounds of Formula:

[0095] in which:

[0096] R₁₀ ¹ is a hydrogen or a lower alkyl;

[0097] R₁₀ ² is a substituted or unsubstituted aryl, an aralkyl or a heterocycle;

[0098] R₁₀ ³ is a hydrogen or a methyl;

[0099] X₁₀ is an alkylene or an alkenylene which may be substituted with one or more fluorine atoms and whose chain may be interrupted by an oxygen, a sulphur and/or a phenylene;

[0100] Y₁₀ is a straight or branched alkylene or an alkenylene, an oxygen or a sulphur;

[0101] m₁₀ is 0 or 1;

[0102] n₁₀ is 0, 1 or 2,

[0103] which are described in EP 226 346.

[0104] XI—AA 2414 and the Compounds of Formula:

[0105] in which:

[0106] R₁₁ ¹ is optionally a substituted phenyl group,

[0107] R₁₁ ² is optionally a substituted amino group and

[0108] n₁₁ is an integer from 3 to 10 or a hydroquinone derivative thereof, as described in EP 232 089 A2.

[0109] XII—CV 6504 and the Compounds of Formula:

[0110] in which:

[0111] R₁₂ ¹ and R₁₂ ², which are identical or different, represent a hydrogen atom, a methyl or hydroxyl group, or alternatively R₁₂ ¹ and R₁₂ ² are linked so as to form —CH═CH—CH═CH—;

[0112] R₁₂ ³ is a hydrogen atom or a methyl group;

[0113] R₁₂ ⁴ is a heterocyclic group containing a nitrogen atom which may be substituted;

[0114] R₁₂ ⁵ is a hydrogen atom, a methyl or hydroxymethyl group which may be substituted, or a carboxyl group which may be esterified, or in the form of an amide;

[0115] Z₁₂ is

[0116] in which R′₁₂ is a hydrogen atom or a methyl group;

[0117] n₁₂ is an integer from 0 to 12, m₁₂ is an integer from 0 to 3, and k₁₂ is an integer from 0 to 7, with the proviso that when m₁₂ is 2 or 3, Z₁₂ and k₁₂ are capable of varying appropriately in the repeated unit described in [] and the hydroquinone derivatives of those described in EP 234729.

[0118] XIII—HN 11500, Linotroban as well as the 2-thienyl-oxyacetic Acid Derivatives of Formula:

[0119] in which R₁₃ is a phenyl or thienyl group which is substituted, where appropriate, once or several times with a halogen atom, a trifluoromethyl group or an alkyl group of 1 to 4 carbon atoms, as well as their pharmaceutically acceptable salts, as described in EP 284 892.

[0120] XIV—ICI 192605 or a 2,4-diphenyl-1,3-dioxane Derivative of Formula:

[0121] in which:

[0122] X₁₄ is F, Cl, Br, CF₃, CN, OMe or NO₂;

[0123] Y₁₄ or Z₁₄ is independently hydrogen or F and the other is hydrogen; and

[0124] R′₁₄ is a (C₁-C₆)alkyl;

[0125] the groups at the 2-, 4- and 5-positions of the dioxane ring having a cis stereochemistry, as well as their pharmaceutically acceptable salts, as described in EP 201354.

[0126] XV—OKY 046 or Ozagrel and its Analogues of Formula:

[0127] in which:

[0128] R₁₅ is a hydrogen atom or a (C₁-C₆)alkyl group;

[0129] A₁₅ and B₁₅, which are identical or different, represent a bond, a straight or branched (C₁-C₈)alkylene or a (C₂-C₈)alkenylene;

[0130] n₁₅ and m₁₅, which are identical or different, are 0 or 1, whereas A₁₅and B₁₅ consist of 2, 3 or 4 carbon atoms, as well as its pharmaceutically acceptable salts, as described in DE 2,923,815.

[0131] XVI—Y 20811 and the Imidazole Derivatives of Formula:

[0132] in which:

[0133] each of the groups R₁₆ ¹ and R₁₆ ⁴ is a hydrogen atom or a (C₁-C₄)alkyl group;

[0134] each of the groups R₁₆ ² and R₁₆ ³ is a hydrogen atom, a halogen atom, a hydroxyl group, a (C₁-C₄)alkyl group, a (C₁-C₄)alkoxy group, a benzyloxy group, a phenethyloxy group, a nitro group or an amino group;

[0135] A₁₆ is an —O—, —S—, —CH═CH— or —CH═N— group;

[0136] Z₁₆ is a phenyl group, a naphthyl group, a thienyl group, a pyridyl group or a furyl group, in which definition these (heterocyclic) aromatic rings comprise 1 to 3 substituents, each substituent being independently selected from a halogen atom, a (C₁-C₄)alkyl group, a (C₃-C₆)cycloalkyl group, a (C₁-C₄)alkoxy group, a hydroxyl group, a carboxyl group, a (C₁-C₄)alkoxycarbonyl group, a carboxy(C₁-C₄ alkoxy) group, a (C₁-C₄)dialkylamino(C₁-C₄ alkoxy) group and a nitro group, or an addition salt of this derivative with a pharmaceutically acceptable acid, as described in EP 110996.

[0137] XVII—RS 5186 and the Compounds of Formula:

[0138] in which:

[0139] R₁₇ ¹ and R₁₇ ² are identical or different and each represent a hydrogen atom, a (C₁-C₄)alkyl group, a carbocyclic (C₆-C₁₀)aryl group or a substituted carbocyclic (C₆-C₁₀)aryl group having at least one of the substituents (a) below;

[0140] n₁₇ is 1 or 2;

[0141] one of A₁₇ ¹ or A₁₇ ² represents a group of formula -Z₁₇-Y₁₇ in which Y₁₇ represents an imidazolyl or pyridyl group and Z₁₇ represents a methylene, ethylene, trimethylene or vinylene group or a methylene, ethylene, trimethylene or vinylene group having at least one of the substituents (b) below;

[0142] the other, which is either A₁₇ ¹ or A₁₇ ² represents a group of formula —W₁₇—COOH, in which W₁₇ represents a bond, a methylene group, a ═CH— group, an ethylene group, a vinylene group, the said group being optionally substituted with at least one of the substituents (c) below, with the proviso that W₁₇ represents only the said ═CH— group when A₁₇ ¹ represents the said group -Z₁₇-Y₁₇;

[0143] A₁₇ ² is at the 5 or 6-position of the bicyclic system;

[0144] each dotted line represents a carbon-carbon single or double bond between the 4- and 5- or 6- and 7-positions, it being understood that when A₁₇ ² is at the 5-position, the bond between the 6- and 7-positions is a single bond and that when A₁₇ ² is at the 6-position, the bond, between the 4- and 5-positions is a single bond;

[0145] the substituents (a) being (C₁-C₄)alkyl groups, (C₁-C₄)alkoxy groups, aliphatic carboxylic (C₂-C₆)acyloxy groups, aromatic carboxylic acyloxy groups, aliphatic carboxylic (C₂-C₅)acylamino groups, aromatic carboxylic acylamino groups, trifluoromethyl groups, halogen atoms, nitro groups, cyano groups, amino groups, (C₁-C₄)alkylamino groups, dialkylamino groups in which each alkyl portion is a (C₁-C₄), carboxyl groups and esters and amides of the said carboxyl groups, the acyl portions of the said aromatic acyloxy groups and of the aromatic acylamino groups being carbocyclic (C₆-C₁₀)aryl groups which are unsubstituted or which are at least substituted with a (C₁-C₄)alkyl, a (C₁-C₄)alkoxy or a halogen substituent;

[0146] the substituents, (b) being (C₁-C₄)alkyl groups, (C₃-C₆)cycloalkyl groups, (C₆-C₁₀)aryl groups, (C₆-C₁₀))aryl groups substituted with at least one substituent (a) and the heterocyclic groups having from 5 to 10 atoms in the ring, in which 1 to 3 of the said atoms are nitrogen and/or oxygen and/or sulphur heteroatoms, the said heterocyclic groups being unsubstituted or having at least one substituent selected from (a), (c) or oxygen atoms; and

[0147] the substituents (c) being (C₁-C₄)alkyl groups, (C₆-C₁₀)aryl groups and substituted (C₆-C₁₀)aryl groups having at least one substituent (a) and its pharmaceutically acceptable salts, its amides and its esters, as described in EP 240 107.

[0148] XVIII—FCE 22 178 and the Compound of Formula:

[0149] in which:

[0150] the symbol

represents a single or double bond;

[0151] Z₁₈ represents a single bond or is a —CH₂— group;

[0152] R₁₈ ¹, R₁₈ ², R₁₈ ³ and R₁₈ ⁴ are identical or different and represent (a) a hydrogen, a hydroxyl, a halogen, a (C₁-C₄)alkyl, a (C₁-C₄)alkoxy, a (C₂-C₄)acyl or hydroxymethyl, a (C₁-C₄)alkanoyl, a CONH₂, or a COOR′₁₉ in which R′₁₈ represents a hydrogen or a (C₁-C₄)alkyl; or

[0153] (b) a residue from R₁₈ ¹, R₁₈ ², R₁₈ ³ and R₁₈ ⁴ represents —CH═CH—COOR′₁₈ or an —O—C(R′₁₈R″₁₈) COOR′₁₈ or a (C₁-C₄)alkyl, the other residues having the meaning defined above in (a), as well as their pharmaceutically acceptable salts, as described in DE 33 24 069.

[0154] XIX—Furegrelate and its Analogues of Formula:

[0155] in which:

[0156] Z₁₉ ¹ is 4-pyridinyl, 3-pyridinyl, 4-methyl-3-pyridinyl, 4-methoxy-3-pyridinyl, 4-dimethylamino-3-pyridinyl, 4-amino-3-pyridinyl, 4-dimethylamino-3-pyridinyl, 4-amino-3-pyridinyl, 2-, 4-, 5- or 6-chloro-3-pyridinyl, an imidazolyl or a ((C₁-C₃)alkyl) imidazolyl;

[0157] X₁₉ ¹ is —(CH₂)n₁₉-, —O—, —S—, —SO—, —SO₂— —CH₂—O—, —O—CH₂—, —CH₂—NR193-, —NR₁₉ ³—CH₂—, —CHOH— or —CO— in which n₁₉ is an integer from 0 to 4 and R₁₉ ³ is a hydrogen, a methyl, with the proviso that Z₁₉ ¹ is an optionally substituted pyridinyl as defined above when X₁₉ ¹ is not —(CH₂)_(n19)—, —CHOH— or —O—CH₂—;

[0158] Y¹ ₁₉ is an oxygen or sulphur atom, provided that X¹ ₁₉ is not —SO— or —SO— when Y¹ ₁₉ is —S—;

[0159] R₁₉ ² is a hydrogen, a (C₁-C₃)alkyl, a phenyl, or —COOR₁₉ ¹; in which R₁₉ ¹ is hydrogen, a pharmaceutically acceptable cation, a (C₁-C₁₂)alkyl, a (C₁-C₃)cycloalkyl, a (C₇-C₁₂)aralkyl, a phenyl optionally substituted with up to 3 substituents independently selected from chlorine, a (C₁-C₃)alkyl, or a phenyl para-substituted with an —NHCO—R₁₉ ²⁵, —O—CO—R₁₉ ²⁶, —CO—R₁₉ ²⁴, O—CO—(p-Ph)—, R₁₉ ²⁷ or —CH═N—NH—CO—NH₂ in which R₁₉ ²⁴ is a phenyl or an acetamidophenyl, R₁₉ ²⁵ is methyl, phenyl, acetamidophenyl, benzamidophenyl or an amino, R₁₉ ²⁶ is a methyl, phenyl, an amino or a methoxy, R₁₉ ²⁷ is a hydrogen or an acetamido, and p-Ph is a 1,4-phenylene;

[0160] R₁₉ ⁷ is a hydrogen, —CH₂OH—; —COOR₁₉, in which R₁₉ ¹ is as defined above —CN or —C₂N(R₁₉ ⁴)₂, CO—N (R₁₉ ⁴)₂ or —CO—R₁₉ ⁴ in which R₁₉ ⁴ is a hydrogen, a (C₁-C₄)alkyl, or a phenyl;

[0161] either R₁₉ ⁹ and R₁₉ ¹² are independently selected from a hydrogen, hydroxyl, (C₁-C₄)alkyl, fluorine, chlorine, bromine and methoxy, or R₁₉ ⁹ and R₁₉ ¹² are bonded to adjacent carbon atoms and together represent —O—CH₂—C—;

[0162]

represents a single bond (in this case, the compound may be an enantiomer or a racemate) or a double bond;

[0163] m₁₉ is an integer from 0 to 4;

[0164] or one of its pharmaceutically acceptable acid addition salts, as described in EP 069 521.

[0165] XX—Ridogrel or One of its Analogues of Formula:

[0166] in which:

[0167] R₂₀ is a hydrogen, a (C₁-C₁₀)alkyl, a trifluoromethyl, an Ar₂₀ radical or a radical Ar₂₀—(C₁-C₁₀)alkyl; in which Ar₂₀ is a phenyl, a naphthyl, a pyridinyl, a pyrimidinyl, a furanyl or a thienyl, the said phenyl and naphthyl being optionally substituted with up to 3 substituents independently selected from (C₁-C₆)alkyl, (C₁-C₆)alkoxy, a mono- and di((C₁-C₆)alkyloxy)methyl, an amino, a (C₁-C₅)alkylcarbonylamino, a carboxyl, a formyl, a halogen, a hydroxyl, a nitro and a trifluoromethyl;

[0168] R₂₀ ¹ is a hydrogen or a (C₁-C₆)alkyl; and

[0169] Alk₂₀ is a (C₂-C₁₀)alkylene radical;

[0170] with the proviso that the radical C₅H₄N—C(R₂₀)═N—O— and the radical —COOR₂₀ ¹ are not bonded to the same carbon atom, it being possible for these compounds to be in the form of an N-oxide, of an addition product with a pharmaceutically acceptable acid, of a metal salt or of an ammonium salt, or a stereochemically isomeric form of these compounds, as described in EP 221601.

[0171] XXX—Isbogrel and its Analogues of Formula:

[0172] in which:

[0173] R₂₁ ¹ is a pyridyl group,

[0174] R₂₁ ² is a phenyl group, a, thienyl group, a furyl group, a naphthyl group, a benzothienyl group or a pyridyl group which may be optionally substituted with a lower alkoxy group, a lower alkyl group, a halogen atom, a trifluoromethyl group, a lower alkenyl group or a methylenedioxy group,

[0175] R₂₁ ³ is a hydrogen atom or a lower alkyl group, and

[0176] n₂₁ is an integer from 0 to 6,

[0177] as described in EP 098 690.

[0178] XXII—Abciximab, a Class IgG₁ Monoclonal Antibody Manufactured According to WO/06133.

[0179] XXIII—Integrelin and its Analogues Containing at Least 5 Contiguous Amino Acids of an Oligopeptide Selected From: (a) Gly-Ser-Pro-Arg-Cys-Asp-Leu-Lys-Glu-Asn-Leu- Leu-Lys-Asp-Asn-Cys-Ala-Pro-Z₂₃; (b) Ala-Arg-Val-Leu-Glu-Asp-Arg-Pro-Leu-Ser-Asp- Lys-Gly-Ser-Gly-Asp-Ser-Ser-Gln-Val-Z₂₃; (c) Asp-Gln-Val-Thr-Arg-Phy-Asn-Glu-Glu-Val-Lys- Lys-Gln-Ser-Val-Ser-Arg-Asn-Arg-Asp-Z₂₃; (d) Glu-Glu-Val-Lys-Lys-Gln-Ser-Val-Ser-Arg-Asn- Arg-Asp-Ala-Pro-Glu-Gly-Gly-Phe-Asp-Z₂₃ and (e) Asn-Glu-Glu-Val-Lys-Lys-Gln-Ser-Val-Ser-Arg- Asn-Arg-Asp-Ala-Pro-Glu-Gly-Gly-Phe-Asp-Ala- Ile-Met-Gln-Ala-Z₂₃; (f) Ser-Val-Ser-Arg-Asn-Arg-Asp-Ala-Pro-Glu-Gly- Gly-Phe-Asp-Ala-Ile-Met-Gln-Ala-Z₂₃; or (g) Ser-Val-Ser-Arg-Asn-Arg-Asp-Ala-Pro-Glu-Gly- Gly-Z₂₃;

[0180] in which Z₂₃, if present, is OH and the oligopeptide has less than 50 combined native amino acids described in WO 90/00178.

[0181] XIV—SC 52012 and its Analogues of Formula:

[0182] in which:

[0183] R₂₄ ¹ and R₂₄ ² are each independently selected from hydrogen; a phenyl; a substituted phenyl in which each substituent may be selected from a group consisting of a (C₁-C₆)alkyl, a halogen, a (C₁-C₆)alkoxy, a trifluoromethyl, a hydroxyl and a carboxyl; a (C₁-C₆)alkyl; a heterocycle consisting of a 5- or 6-membered ring comprising a heteroatom selected from: nitrogen, oxygen and sulphur, fused with a benzene ring;

[0184] P₂₄ is hydrogen, a carboxyl or a (C₁-C₆)alkoxycarbonyl;

[0185] W₂₄ is hydrogen or a (C₁-C₆)alkyl;

[0186] Y₂₄ is a methylene, a (C₂-C₄)alkenyl, a (C₂-C₄)alkynyl or a carbonyl;

[0187] Z₂₄ is a halogen, a (C₁-C₆) alkoxy, a (C₁-C₆)alkyl or a hydrogen;

[0188] n₂₄ is an integer from 1 to 6;

[0189] with the proviso that when P₂₄, W₂₄ and Z₂₄ each represent hydrogen, Y₂₄ is a methylene at the meta position of the aminoiminomethyl group and n₂₄ is 3, then R₂₄ ¹ cannot be phenyl; as q well as the pharmaceutically acceptable salts described in EP 502536.

[0190] XXV—TP 9201

[0191] A composition comprising a cyclic RGD containing a peptide having a hydrophobic entity adjacent to the carboxyl end of the said RGD sequence.

[0192] XXVI—RO 44-9883 or One of its Analogues of Formula:

[0193] in which L₂₆ is a group of formula

[0194] or alternatively represents R^(o) ₂₆—NH(CH₂)t₂₆,

[0195] R₂₆ is an amidino or a guanidino, X₂₆ or Y₂₆ being CH and the other CH or N,

[0196] R′₂₆ being hydrogen or an amidino,

[0197] t₂₆ being an integer between 2 and 6,

[0198] R′₂₆, R″₂₆ and R′″₂₆ being independently hydrogen or the conventional substituents of the nitrogen atom of the α-amino acids, or the conventional side chains of the α-amino acids, it being possible for the hydroxyl or carboxyl groups present in R′, R″ and R′″ to be etherified, esterified or in the form of amides, and it being possible for the amino groups present in R′, R″ and R′″ to be alkanoylated or aroylated;

[0199] Q₂₆ is a group of formula

[0200] —N (V′₂₈) (CH₂)_(v26)—C(V″₂₆, V″′₂₆) CH₂OCH₂COO-T₂₆ (Q⁸ ₂₆) or when R′₂₆ and R″₂₆ together form a ring with the N or C atom to which they are bonded, Q₂₆ may also represent the group:

[0201] n₂₆ represents 0 or 1,

[0202] v₂₆ is an integer between 0 and 3,

[0203] T₂₃ and T′₂₆ are hydrogen or represent a lower alkyl group or a lower phenylalkyl which is cleavable under physiological conditions;

[0204] V₂₆ to V′″₂₆ is hydrogen or a lower alkyl group;

[0205] U₂₆ and U′₂₆ are hydrogen, a (C₁-C₆)alkanoyl or aroyl,

[0206] Ar₂₆ is an aryl and

[0207] R₂₆ ² to R₂₆ ⁵ are hydrogen, a lower alkyl, a lower alkoxy, a halogen or a group-OCH₂COO-T′₂₆ or

[0208] R₂₆ ² and R₂₆ ³ together form with the phenyl group to which they are bonded a 1-naphthyl group as well as their hydrates and solvates and their pharmaceutically acceptable salts, as described in EP 505 868.

[0209] XXVII—RO 43-8857 and its Analogues of Formula:

R¹ ₂₇-A₂₇-(W₂₇)_(a27)—X₂₇—(CH₂)_(b27)—Y₂₇)_(c27)—B₂₇-Z₂₇-COOR₂₇   (XXVII)

[0210] in which:

[0211] A₂₇ denotes a residue

[0212] B₂₇ denotes a residue

[0213] and

[0214] W₂₇ represents —CH₂—, —CH₂CH₂—, —CH═CH—, —CH═CH—CH₂—, —(CH₂)₃—, —CH₂CH(CH₃)—, —COCH₂—, —CH(OH)CH₂— or —CH₂COCH₂;

[0215] X₂₇ represents —CONR₂₇ ², —NR₂₇ ²CO—, —SO₂NR₂₇ ²— or —NR₂₇ ²SO₂—;

[0216] Y₂₇ represents —CH₂CH₂—, —CH₂CH₂O—, —OCH₂—, —CH(CH₃)CH₂—, —CH═CH—, —CH₂—CH═CH—, —C(Q₂₇ ¹) (Q₂₇ ²)-CO(CH₂)d₂₇-, —CH₂—, —CH₂CH₂CH₂—, —CH (CH₃)CH₂CH₂—, —CH₂COCH₂—, —C-(Q₂₇ ¹)(Q₂₇ ²)-CH(OH)—, —C(Q₂₇ ¹) (Q₂₇ ²)-CH(SSCH₃)—, —CH(CH₂OH)CH₂— or —CH(COOR₂₇)CH₂—, whereas the carbonyl groups may also be present in the form of oxime, oxime ether, ketal or thioketal or enol ether groups and the hydroxyl groups in the form of lower alkyl ether groups, di (lower alkyl)amino(lower alkyl) ether groups or in the form of lower arylcarboxylic acid ester groups,

[0217] Z₂₇ denotes —OCH₂—, —NR₂₇ ⁶CH₂—, —CH₂CH₂—, —CH(CH₃)CH₂—, —CH₂—, —CH═CH— or —C(CH₃)═CH—;

[0218] R₂₇ represents hydrogen or a lower alkyl, phenyl or phenyl(lower alkyl) group;

[0219] Q27¹ and Q₂₇ ² are hydrogen or an alkyl group or form with the carbon atom to which they are bonded a 3- to 6-membered saturated ring;

[0220] R₂₇ ¹ denotes an amidino or guanidino group;

[0221] R₂₇ ² denotes hydrogen or a lower alkyl group, a phenyl(lower alkyl) group, a phenyl(lower alkyl) group substituted in the phenyl portion with amino, amidino or —COOR₂₇ radicals, or a —CH₂COOR₂₇ or Y₂₇—B₂₇-Z27-COOR₂₇ residue;

[0222] R₂₇ ³, represents hydrogen or a lower alkyl, lower alkoxy, halogen, lower alkoxycarbonyl, amino, lower alkylamino, di(lower alkyl)amino or amidino group;

[0223] R₂₇ ⁴ represents hydrogen or a lower alkyl, lower alkoxy, halogen, lower alkoxycarbonyl, amino, lower alkylamino, di (lower alkyl)amino group or a -Z₂₇-COOR₂₇ or —CH═CH—(CH₂)n₂₇COOR₂₇ residue;

[0224] R₂₇ ⁶ denotes hydrogen or a lower alkyl or benzyl group;

[0225] n₂₇ represents an integer from 0 to 4;

[0226] a₂₇, c₂₇ and d₂₇ are independent of each other, 0 or 1; and

[0227] b₂₇ denotes an integer from 0 to 2, whereas nevertheless a₂₇ and b₂₇ should be equal to 0 when c₂₇ is 1 and, C₂₇ should be equal to 0 when a27 or b₂₇ is different from 0;

[0228] as well as their physiologically acceptable salts, as described in EP 381 033.

[0229] XXVIII—RO 43-5054 and its Acetic Acid Derivatives of Formula:

H₂N (HN)C—X₂₈—Y₂₈—CO-Z₂₈-CH (Q₂₈ ¹) COOQ₂₈ ²   (XXVVIII)

[0230] in which:

[0231] Q₂₈ ¹ is hydrogen, a methyl or phenyl,

[0232] Q₂₉ ² is hydrogen, a phenyl(lower alkyl), or a lower alkyl which is cleavable under physiological conditions;

[0233] X₂₈ is a 1,4-phenylene; 2,5-pyridylene or 3,6-pyridylene or a 1,4-piperidinylene group attached to the group Y by the carbon atom at the 4-position;

[0234] Y₂₈ is a group of formula —(CH₂)₀₋₂—CONHCH(Q₂₈ ³) (CH₂)₁₋₃, —CONHCH₂CH (Q₂₈ ⁴)-, —(CH₂)₂NHCOCH₂—, —NHCO(CH₂)₃—,

[0235] Q₂₈ ³ is a hydrogen, a methyl, a phenyl, a —COOH, —COO(lower alkyl), a CONH(CH₂)₂—COOH or a —CONH—(CH₂)₂—COO(lower alkyl),

[0236] Q₂₈ ⁴ is a hydrogen, a methyl or a phenyl,

[0237] Z₂₈ is a 1,4-piperazinylene group, a 1,4-piperidinylene group bonded to the CO group via the nitrogen atom at the 1-position or a group of formula —NHCH(R₂₈ ¹)— or —NHCH(COR₂₈ ²)— in which

[0238] R₂₀ ¹ is a hydrogen, a methyl, a phenyl or a —COO(lower alkyl),

[0239] R₂₈ ² is an α-amino acid residue bonded via its amino group or the ester or amide of the latter, or a group of formula

[0240] NHCH₂CH₂—Ar₂₈ or —CO—R₂₈ ² represents a carbamoyl group which is optionally mono- or dialkylated by a lower alkyl group or a pyrrolidinocarbonyl or piperidinocarbonyl group;

[0241] Ar₂₈ is a phenyl or a phenyl substituted with a lower alkyl, a lower alkoxy, a —COOH, a —COO(lower alkyl), a —O(CH₂)₁₋₄—COOH, a —O(CH₂)₁₋₄—COO(lower alkyl), a —CONH₂, a —CONH(lower alkyl), or a —CON(lower alkyl)₂, a pyrrolidinocarbonyl or a piperidinocarbonyl, as well as their hydrates, their solvates and their pharmaceutically acceptable salts, as described in EP 445796.

[0242] XXIX—MK 0383 and its Analogues of Formula:

[0243] in which:

[0244] R¹ ₂₉ is a heterocyclic ring consisting of 4 to 8 members containing 1, 2, 3 or 4 heteroatoms in which the said heteroatoms are N, O or S and the said heterocyclic ring is optionally substituted on any atom with R⁶ ₂₉ or R⁷ ₂₉; NR⁶ ₂₉R⁷ ₂₉;

[0245] in which:

[0246] R⁶ ₂₉ and R⁷ ₂₉ are independently a hydrogen, and a (C₁-C₁₀)alkyl group or a substituted or unsubstituted cycloalkyl group in which the said substituents are (C₁-C₁₀)alkoxy, (C₁-C₁₀) alkoxyalkyl, (C₁-C₁₀)alkoxy-alkyloxy, (C₁-C₁₀)alkoxycarbonyl, (C₁-C₁₀)alkylcarbonyl, (C₄-C₁₀)aralkylcarbonyl, (C₁-C₁₀)alkylthiocarbonyl, (C₁-C₁₀)aralkylthiocarbonyl, thiocarbonyl, (C₁-C₁₀)-alkoxythiocarbonyl, aryl, a saturated heterocycle with 5 or 6 saturated members containing 1, 2, 3 or 4 heteroatoms in which the said heteroatoms are selected from the group consisting of N, O and S, (C₁-C₄)alkanoylamino, (C₁-C₆)alkoxycarbonyl-(C₀-C₆)alkylamino, (C₁-C₁₀)alkylsulphonylamino, (C₄-C₁₀)aralkylsulphonylamino, (C₄-C₁₀)aralkyl, (C₁-C₁₀)alkaryl, (C₁-C₁₀)alkylthio, (C₄-C₁₀)aralkylthio, (C₁-C₁₀)alkylsulphinyl, (C₄-C₁₀)aralkylsulphinyl, (C₁-C₁₀)alkylsulphonyl, (C₄-C₁₀)aralkylsulphonyl, aminosulphonyl, (C₁-C₁₀)alkylaminosulphonyl, (C₄-C₁₀)aralkylsulphonylamino, oxo, thioxo, an unsubstituted, a monosubstituted or a disubstituted 1-ethynyl, 2-ethynyl or 3-propenyl group, in which the said substituents are selected from the group consisting of hydrogen, (C₁-C₁₀)alkyl and (C₄-C₁₀)aralkyl, carboxyl, hydroxyl, amino, (C₁-C₆)alkylamino, (C₁-C₆)dialkylamino, halogen in which the halogen is selected from F, Cl, Br, and I, nitro, and cyano;

[0247] it being possible for the nitrogen atom of the said heterocyclic ring to be, in addition, substituted with an additional R⁶ ₂₉ group to form a quaternary ammonium ion;

[0248] R² ₂₉ and R³ ₂₉ are independently hydrogen, aryl or a (C₁-C₁₀)alkyl or cycloalkyl group, unsubstituted or substituted, in which the said substituent is a (C₁-C₁₀)alkoxyalkyl, aryl, a saturated heterocycle having from 4 to 8 members containing 1, 2, 3 or 4 heteroatoms in which the heteroatoms are selected from the groups consisting of N, O and S, (C₄-C₁₀)aralkyl, (C₁-C₁₀)alkaryl, (C₁-C₁₀)alkylthio, (C₄-C₁₀)aralkylthio, (C₁-C₁₀)alkylsulphinyl, (C₄-C₁₀)aralkylsulphinyl, (C₁-C₁₀)alkylsulphonyl, (C₄-C₁₀)aralkylsulphonyl, carboxyl, (C₁-C₁₀) alkylcarbonyl, (C₁-C₁₀)alkylthiocarbonyl, (C₄-C₁₀)aralkylcarbonyl, (C₄-C₁₀)aralkylthiocarbonyl, (C₁-C₆)alkoxycarbonyl, (C₄-C₁₀)aralkoxycarbonyl-, (C₁-C₆)alkoxy, (C₁-C₆)alkoxycarbonyl-(C₁-C₄) alkyl, (C₄-C₁₀)aralkoxycarbonyl-(C₁-C₄)alkyl, (C₄-C₁₀)aralkoxy, (C₁-C₆)alkylamino, (C₁-C₁₂)dialkylamino, (C₁-C₆)alkanoylamino, (C₄-C₁₀)aralkanoylamino, (C₄-C₁₀)aralkylamino,

[0249] R⁴ ₂₉ is aryl, (C₁-C₁₀)alkyl or cycloalkyl, (C₄-C₁₀)aralkyl, (C₁-C₁₀)alkoxyalkyl, (C₁-C₁₀)alkaryl, (C₁-C₁₀)alkylthioalkyl, (C₁-C₁₀)alkoxythioalkyl, (C₁-C₁₀)alkylamino, (C₄-C₁₀)aralkylamino, (C₁-C₁₀)alkanoylamino, (C₁-C₁₀)aralkanoylamino, (C₁₀-C₁₀)alkanoyl, (C₄-C₁₀)aralkanoyl, and a substituted or unsubstituted (C₁-C₁₀)carboxyalkyl in which the said substituent is aryl, (C₁-C₁₀)aralkyl; it being possible for each of the substituents of R⁴ ₂₉ to be, in addition, substituted with a substituent selected from the group defined for R⁶ ₂₉;

[0250] R⁵ ₂₉ is a saturated or unsaturated 4- to 8-membered heterocyclic ring containing 1, 2, 3 or 4 heteroatoms selected from N, O and S or

[0251] in which:

[0252] R⁸ ₂₉ is hydroxyl, (C₁-C₁₀)alkyloxy, (C₁-C₁₀)alkaryloxy, (C₄-C₁₀)aralkyloxy, (C₄-C₁₀)aralkylcarbonyloxy, (C₁-C₁₀)alkoxyalkyloxy, (C₁-C₁₀)alkoxyalkylcarbonyloxy, (C₁-C₁₀)alkoxycarbonylalkyl, (C₁-C₁₀)alkylcarbonyloxyalkoxy, or an L- or a D-amino acid bonded via an amide bond, or an amino acid bonded via an amide bond and in which the carboxylic acid functional group of the said amino acid is optionally esterified with a (C₁-C₆)alkyl or a (C₄-C₁₀)aralkyl, or R⁸ ₂₉ represents:

[0253] in which:

[0254] R⁹ ₂₉ and R¹⁰ ₂₉ are selected from the group consisting of hydrogen, (C₁-C₁₀)alkyl and (C₄-C₁₀)aralkyl;

[0255] X₂₉ and Y₂₉ are optional substituents which, when present, represent NR⁶ ₂₉, O, S, SO, SO₂,

[0256] a ring having from 4 to 8 members containing 0, 1, 2, 3 or 4 heteroatoms selected from N, O and S, in which the said ring is independently substituted on any of its atoms with R⁶ ₂₉, an aryl, or

[0257] or —NR⁶ ₂₉SO₂; —SO₂NR⁶ ₂₉—;

[0258] Z₂₉ is an optional substituent which, when present, is independently selected from the substituents defined for X₂₉ and Y₂₉;

[0259] m₂₉ is an integer from 0 to 10;

[0260] n₂₉ is an integer from 0 to 10; and

[0261] p₂₉ is an integer from 0 to 3;

[0262] as well as its pharmaceutically acceptable salts, as described in EP 478 363.

[0263] XXX—Tirofiban or One of its Analogues of Formula:

[0264] in which:

[0265] R₃₀ ¹ is a 4-piperidinyl or a 4-pyridinyl;

[0266] m₃₀ is an integer from 2 to 6; and

[0267] R₃₀ ⁴ is an aryl, a (C₁-C₁₀)alkyl or a (C₄-C₁₀)aralkyl as described in U.S. Pat. No. 5,206,373.

[0268] XXXI—DUP 728 and its Analogues of Formula:

[0269] R₃₁ ³¹ is a saturated, partially saturated or aromatic carbocyclic C₆-C₁₄ ring, substituted with 0 to 2 substituents R₃₁ ¹⁰; or

[0270] n″₃₁ and n′₃₁ are independently an integer from 0 to 3;

[0271] R₃₁ ¹ and R₃₁ ²² are independently selected from the following groups:

[0272] hydrogen, (C₁-C₈)alkyl substituted with 0 to 2 substituents, R₃₁ ¹¹, a (C₂-C₈)alkenyl substituted with 0 to 2 substituents R₃₁ ¹¹ a (C₃-C₈)alkynyl substituted with 0 to 2 substituents R₃₁ ¹¹, a (C₃-C₈) cycloalkyl substituted with 0 to 2 substituents R₃₁ ¹¹, a (C₆-C₁₀)bicycloalkyl substituted with 0 to 2 substituents R₃₁ ¹¹ an aryl substituted with 0 to 2 substituents R₃₁ ¹², a heterocycle substituted with 0 to 2 substituents R₃₁ ¹², composed of 5 to 10 atoms including from 1 to 3 heteroatoms of nitrogen, S or O, ═O, F, Cl, Br, I, —CF₃, —CN, —CO₂R₃₁ ¹³, —C(═O)R₃₁ ¹³, —C(═O)N₃₁ ¹³R₃₁ ¹⁴, —CHO, —CH₂OR₃₁ ¹³, —OC(═O)R₃₁ ¹³, —OC(═O)OR₃₁ ¹³, —OR₃₁ ¹³, —OC(═O) NR₃₁ ¹³R₃₁ ¹⁴, —NR₃₁ ¹⁴C(═O) R₃₁ ¹³, —NR₃₁ ¹⁴C(═O)OR₃₁ ¹³, —NR₃₁ ¹³C(═O)NR₃₁ ¹³R₃₁ ¹⁴, —NR₃₁ ¹⁴SO₂NR₃₁ ¹³R₃₁ ¹⁴, —NR₃₁ ¹⁴SO₂R₃₁ ¹³, —SO₃H, —SO₂R₃₁ ¹³, —SR₃₁ ¹³, —S(═O)R₃₁ ¹³, —SO₂NR₃₁ ¹³R₃₁ ¹⁴, —NR₃₁ ¹³R₃₁ ¹⁴, —NHC(═NH)NHR₃₁ ¹³, —C(═NH)NHR₃₁ ¹³, ═NOR₃₁ ¹⁴, NO₂, —C(═O) NHOR₃₁ ¹³. —C(═O)NHNR₃₁ ¹³R₃₁ ¹⁴, oxime, boronic acid, —OCH₂CO₂H, 2-(1-morpholino) ethoxy;

[0273] or R₃₁ ¹ and R₃₁ ²¹ may bond together to form a carbocyclic ring having from 5 to 7 members, substituted with 0 to 2 substituents R₃₁ ¹²;

[0274] or R₃₁ ²² and R₃₁ ²³ may bond together to form a carbocyclic ring having from 5 to 7 members, substituted with 0 to 2 substituents R₃₁ ¹²;

[0275] or R₃₁ ¹ and R₃₁ ², when R₃₁ ²¹ is hydrogen, may become bonded to form a carbocyclic ring having from 5 to 8 members, substituted with 0 to 2 substituents R₃₁ ¹²;

[0276] R₃₁ ¹¹ may be selected from one of the following groups: ═O, F, Cl, Br, I, —CF₃, —CN, —CO₂R₃₁ ¹³, —C(═O)R₃₁ ¹³, —C(═O) NR₃₁ ¹³R₃₁ ¹⁴, —OHO, —CH₂OR₃₁ ¹³, —OC(═O) R₃₁ ¹³, —C(═O)OR₃₁ ¹³, —OR₃₁ ¹³, —OC(═O)NR₃₁ ¹³R₃₁ ¹⁴, —NR₃₁ ¹⁴C(═O)R₃₁ ¹³, —NR₃₁ ¹⁴C(═O)OR₃₁ ¹³, —NR₃₁ ¹³C(═O)NR₃₁ ¹³R₃₁ ¹⁴, —NR₃₁ ¹⁴SO₂NR₃₁ ¹³R₃₁ ¹⁴, —NR₃₁ ¹⁴SO₂R₃₁ ¹³, SO₃H, —SO₂R₃₁ ¹³, SR₃₁ ¹³, —S(═O)R₃₁ ¹³, —SO₂NR₃₁ ¹³R₃₁ ¹⁴, —NR₃₁ ¹³R₃₁ ¹⁴, —NHC(═NH)NHR₃₁ ¹³, —C(═NH)NR₃₁ ¹³, ═—NR₃₁ ¹⁴, NO₂, —C(═O)NHOR₃₁ ¹³, —C(═O)NHNR₃₁ ¹³R₃₁ ¹⁴, oxime, boronic acid, —OCH₂CO₂H, 2-(1-morpholino)ethoxy, a (C₁-C₅)alkyl, a (C₂-C₁₄)alkenyl, a (C₃-C₆)cycloalkyl, a (C₃-C₆)cycloalkylmethyl, a (C₂-C₆)alkoxyalkyl, a (C₃-C₆)cycloalkoxy, a (C₁-C₄)alkyl, (substituted with an —NR₃₁ ¹³R₃₁ ¹⁴, a —CF₃, an NO₂, an SO₂R₃₁ ^(13a) or an —S(═O)R₃₁ ^(13a), an aryl substituted with 0 to 2 substituents R₃₁ ¹², a heterocyclic ring substituted with 0 to 2 substituents R₃₁ ¹², composed of 5 to 10 atoms including from 1 to 3 heteroatoms of nitrogen, oxygen or sulphur;

[0277] R₃₁ ¹² is selected from one or more of the following groups:

[0278] a phenyl, benzyl, phenethyl, phenoxy, benzyloxy, halogen, hydroxyl, nitro, cyano, (C₁-C₅)alkyl, (C₃-C₆)cycloalkyl (C₃-C₆) cycloalkylmethyl, (C₇-C₁₀) arylalkyl, (C₁-C₄)alkoxy, —CO₂R₃₁ ¹³, —C(═O)NHC₃₁ ¹³, —O(═O)NHNR₃₁ ¹³R₃₁ ¹⁴, oxime, boronic acid, (C₃-C₆)cycloalkoxy, —OC(═O)R₃₁ ¹³, —C(═O)R₃₁ ¹³, —OC(═O)OR₃₁ ¹³, —OR₃₁ ¹³, —CH₂OR₃₁ ¹³, —NR₃₁ ¹³R₃₁ ¹⁴, —OC(═O)NR₃₁ ¹³R₃₁ ¹⁴, —NR₃₁ ¹⁴C(═O)R₃₁ ¹³, —NR₃₁ ¹⁴C(═O)OR₃₁ ¹³, —NR₃₁ ¹³C(═O) NR₃₁ ¹³R₃₁ ¹⁴, —NR₃₁ ¹⁴SO₂NR₃₁ ¹³R₃₁ ¹⁴, —NR₃₁ ¹⁴SO₂R₃₁ ^(13a), —SO₃H, —SO₂R₃₁ ^(13a), —S(═O)R₃₁ ^(13a), —SR₃₁ ¹³, —SO₂NR₃₁ ¹³R₃₁ ¹⁴, (C₂-C₆)alkoxyalkyl, (C₁-C₄)hydroxyalkyl, methylenedioxy, ethylenedioxy, (C₁-C₄)haloalkyl, (C₁-C₄)haloalkoxy, (C₁-C₄)alkoxycarbonyl, (C₁-C₄)alkylcarbonyloxy, (C₁-C₄)alkylcarbonyl, (C₁-C₄)alkylcarbonylamino, —OCH₂CO₂H, 2-(1-morpholino)ethoxy, (C₁-C₄)alkyl (substituted with an —NR₃₁ ¹³R₃₁ ¹⁴, CF₃, NO₂ or with an —S(═O)R₃₁ ^(13a));

[0279] R₃₁ ¹³ is H, (C₁-C₇)alkyl an aryl, —((C₁-C₆)alkyl)aryl or a (C₃-C₆)alkoxyalkyl;

[0280] R₃₁ ^(13a) is a (C₁-C₇)alkyl, an aryl, a —((C₁-C₆)alkyl)aryl, or a (C₃-C₆)alkoxyalkyl;

[0281] R₃₁ ¹⁴ is OH, H, (C₁-C₄) alkyl, or benzyl;

[0282] R₃₁ ²¹ and R₃₁ ²³ are independently selected from:

[0283] hydrogen; (C₁-C₄)alkyl optionally substituted with a halogen; a (C₁-C₂)alkoxy; a benzyl;

[0284] R₃₁ ² is H or a (C₁-C₈)alkyl;

[0285] R₃₁ ¹⁰ is independently selected from one or more of the following groups:

[0286] a phenyl, benzyl, phenethyl, phenoxy, benzyloxy, halogen, hydroxyl, nitro, cyano, (C₁-C₅)alkyl, (C₃-C₆)cycloalkyl, (C₃-C₆)cycloalkylmethyl, (C₇-C₁₀)arylalkyl, (C₁-C₄)alkoxy, —CO₂R¹³ ₃₁, —C(═O)NHOR₃₁ ¹³, —C(═O)NHNR₃₁ ¹³R₃₁ ¹⁴, oxime, boronic acid, (C₃-C₆)cycloalkoxy, —OC(═O)R₃₁ ¹³, —C(═O) R₃₁ ¹³, —OC(═O)OR₃₁ ¹³, —OR₃₁ ¹³, —CH₂OR₃₁ ¹³, —NR₃₁ ¹³R₃₁ ¹⁴, —NR₃₁ ¹³C(═O)NR₃₁ ¹³R₃₁ ¹⁴, —NR₃₁ ¹⁴SO₂NR₃₁ ¹³R₃₁ ¹³R₃₁ ₁₄, —NR₃₁ ¹⁴SO₂R₃₁ ^(13a), —SO₂R₃₁ ^(13a), —S(═O)R₃₁ ^(13a), —SR₃₁ ¹³, —SO₂NR₃₁ ¹³R₃₁ ¹⁴, (C₂-C₆)alkoxyalkyl, (C₁-C₄)hydroxyalkyl, methylenedioxy, ethylenedioxy, (C₁-C₄)haloalkyl, (C₁-C₄)haloalkoxy, (C₁-C₄) alkoxycarbonyl, (C₁-C₄)alkylcarbonyloxy, (C₁-C₄)alkylcarbonyl, (C₁-C₄)alkylcarbonylamino, —OCH₂CO₂H, 2-(1-morpholino)ethoxy, (C₁-C₄)alkyl (substituted with an —NR₃₁ ¹³R₃₁ ¹⁴, CF₃, NO₃ or with an —S(═O)R₃₁ ^(13a));

[0287] J₃₁ is β-Ala or the residue of an amino acid of the L isomer or of the D isomer of structure

[0288] —N(R₃₁ ¹³)C(R₃₁ ⁴) (R₃₁ ⁵)C(═O)—, in which:

[0289] R₃₁ ³ is H or a (C₁-C₈)alkyl;

[0290] R₃₁ ⁴ is H or a (C₁-C₃)alkyl;

[0291] R₃₁ ⁵ is hydrogen, a (C₁-C₆)alkyl substituted with from 0 to 2 substituents R₃₁ ¹¹, a (C₂-C₈)alkenyl substituted with from 0 to 2 substituents R₃₁ ¹¹, a (C₂-C₈)alkynyl substituted with from 0 to 2 substituents R₃₁ ¹¹ a (C₃-C₈) cycloalkyl substituted with from 0 to 2 substituents R₃₁ ¹¹, a (C₆-C₁₀)bicycloalkyl substituted with from 0 to 2 substituents R₃₁ ¹¹, an aryl substituted with from 0 to 2 substituents R₃₁ ¹², a heterocyclic ring substituted with from 0 to 2 substituents R₃₁ ¹², composed of 5 to 10 atoms including from 1 to 3 heteroatoms N, S or O, or

[0292] R₃₁ ⁵ represents ═O, F, Cl, Br, I, —CF₃, —CN, —CO₂R₃₁ ¹³, —C(═O) R₃₁ ¹³, —C(═O)NR₃₁ ¹³R₃₁ ¹⁴, —CH₂OR₃₁ ¹³, —OC(═O)R₃₁ ¹³, —OC(═O)OR₃₁ ¹³, —OR₃₁ ¹³, —OC(═O)NR₃₁ ¹³R₃₁ ¹⁴, —NR₃₁ ¹⁴C(═O)R₃₁ ¹³, —NR₃₁ ¹⁴C(═O)OR₃₁ ¹³, —NR₃₁ ¹³C(═O)NR₃₁ ¹³R₃₁ ¹⁴, —NR₃₁ ¹⁴SO₂NR₃₁ ¹³R₃₁ ¹⁴, —NR₃₁ ¹⁴SO₂R₃₁ ^(13a), —SO₃H, SO₂R₃₁ ^(13a), —SR₃₁ ¹³, —S(═O)R₃₁ ^(13a), —SO₂NR₃₁ ¹³R₃₁ ¹⁴, —NR₃₁ ¹³R₃₁ ¹⁴, —NHC(═NH)NHR₃₁ ¹³, —C(═NH)NHR₃₁ ¹³, ═NOR₃₁ ¹⁴, NO₂, —C(═O)NHOR₃₁ ¹³, —C(═O)NHR₃₁ ¹³R₃₁ ¹⁴, oxime, boronic acid, —OCH₂CO₂H, 2-(1-morpholino)ethoxy, —SC(═NH)NHR₃₁ ¹³, N₃, —Si(CH₃)₃, ((C₁-C₅)alkyl)NHR₃₁ ¹⁶; ((C₀-C₆)alkyl) X₃₁;

[0293] in which q₃₁ is independently 0 or 1,

[0294] —(CH₂)m₃₁S (CH₂)₂X₃₁, in which m₃₁ is 1 or 2; and in which X₃₁ is defined below;

[0295] R₃₁ ³ and R₃₁ ⁴ may also form together

[0296] in which n₃₁=0, 1 and X₃₁ is

[0297] R₃₁ ³ and R₃₁ ⁵, may also form together —(CH₂)t₃₁— (with t₃₁=2−4) or —CH₂SC(CH₃)₂— or

[0298] R₃₁ ⁴ and R₃₁ ⁵ may also form together —(CH₂)u₃₁ in which u₃₁ is 2-5;

[0299] R₃₁ ¹⁶ is selected from an amine protecting group, 1 to 2 amino acids, 1 to 2 amino acids substituted with an amine protecting group;

[0300] K₃₁ is an amino acid of the L isomer or of the D isomer of structure —N(R₃₁ ⁶)CH(R₃₁ ⁷)C(═O)— in which R₃₁ ⁶ is H, or a (C₁-C₈) alkyl, R₃₁ ⁷ is selected from —((C₁-C₇)alkyl) X₃₁,

[0301] in which q₃₁ is independently 0 or 1;

[0302] —(CH₂)m₃₁O—((C₁-C₄)alkyl)-X₃₁ in which m₃₁ s 1 or 2; —(CH₂)m₃₁S((C₁-C₄)alkyl)-X₃₁ in which m₃₁ is 1 or 2 and X₃₁ is selected from

[0303] R₃₁ ⁶ and R₃₁ ⁷ may also form together

[0304] in which n=0, 1 and X₃₁ is

[0305] L₃₁ is —Y₃₁(CH₂)v₃₁C(═O)— in which Y₃₁ is NH, N((C₁-C₃)alkyl)), O or S; and v₃₁ is 1 or 2;

[0306] M₃₁ is the residue of an amino acid of the L isomer or of the D isomer of structure —NR₃₁ ¹⁷—CH(R₃₁ ⁸)C(═O)— in which R₃₁ ¹⁷ is H, (C₁-C₃)alkyl;

[0307] R₃₁ ⁸ is —CH₂CO₂R₃₁ ¹³, —CH₂SO₃R₃₁ ^(13a), —CH(CH₃)CO₂R₃₁ ¹³, —SO₂NR₃₁ ¹³R₃₁ ¹⁴, —CH₂— boronic acid, —CH₂-tetrazole, —NHSO₂CF₃, CONHNHSO₂CF₃, —PO(OR₃₁ ¹³)₂, —PO(OR₃₁ ¹³ )R₃₁ ¹³, —CONHOR₃₁ ¹³—, —SO₂NH-heteroaryl, —CH₂SO₂NH-heteroaryl, —SO₂NHCOR₃₁ ¹³, —CH₂SO₂NHCOR₃₁ ¹³, —CONHSO₂R₃₁ ^(13a), —CH₂CONHSO₂R₃₁ ^(13a), —NHSO₂NHCOR₃₁ ^(13a), —NHCONHSO₂R₃₁ ¹³, —SO₂NHCONR₃₁ ¹³,

[0308] or its pharmaceutically acceptable salts, as described in WO 93/07170.

[0309] XXXIX—L 70-3014 or One of its Analogues of Formula:

[0310] in which:

[0311] X₃₂ is

[0312] in which A₃₂═N and B₃₂═.CH₂— or A₃₂=>CH— and B₃₂═N—R² ₃₂;

[0313] Y₃₂ is

[0314] R₃₂ and R₃₂ ¹ are independently

[0315] hydrogen,

[0316] an aryl in which the aryl is defined as a 5- or 6-membered mono- or polycyclic aromatic ring containing 0, 1, 2, 3 or 4 heteroatoms selected from nitrogen, oxygen and sulphur, the said aryl being unsubstituted or substituted with one or more groups selected from a hydroxyl, a halogen, a cyano, a trifluoromethyl, a (C₃-C₃)alkoxy, a (C₁-C₅)alkylcarbonyloxy, a (C₁-C₅)alkoxycarbonyl, a (C₁-C₅)alkyl, an amino (C₁-C₅)alkyl, a hydroxycarbonyl (C₀-C₅) alkyl or a hydroxy-carbonyl(C₁-C₅)alkoxy; a (C₁-C₅)alkyl unsubstituted or substituted with one or more groups selected from halogen, hydroxyl, (C₁-C₅)alkylcarbonylamino, aryl(C₁-C₅)alkylcarbonylamino, aryloxy, (C₁-C₁₀)alkoxy, (C₁-C₅)alkoxycarbonyl, (C₀-C₅)alkylalminocarbonyl, (C₁-C₅)alkylcarbonyloxy, (C₃-C₈)cycloalkyl, aryl, oxo, amino, (C₁-C₆)alkyl, (C₁-C₃)alkylamino, amino (C₁-C₃)-alkyl, aryl(C₀-C₅) alkylaminocarbonyl, ethylene, phenyl(C₁-C₃)alkylamino, aminocarbonyl (C₀-C₄)alkyl and hydroxycarbonyl(C₀-C₅)alkyl;

[0317] it being understood that the carbon atom to which R₃₂ and R₃₂ ¹ are linked carries only one heteroatom;

[0318] R₃₂ ² , R₃₂ ³ and R₃₂ ⁴ are independently hydrogen, cyano, a (C₁-C₁₂)alkyl unsubstituted or substituted with ore or more (C₁-C₆)alkyl or aryl(C₀-C₄)alkyl groups, it being understood that when R₃₂ ² and R₃₂ ³ are independently a cyano,

[0319] R₃₂ ⁶ is hydrogen, a hydroxylcarbonyl, a hydroxyl, an amino or a (C₁-C₆)alkyl unsubstituted or substituted with one or more groups selected from a (C₁-C₆)alkyl, a (C₁-C₅)alkoxy, a (C₁-C₅)alkoxycarbonyl, a hydroxy-carbonyl (C₀-C₄)alkyl, an aryl, an amino(C₁-C₄)alkyl, an arylaminocarbonyl(C₁-C₄)alkyl, a (C₁-C₄)alkylsulphonyl, a phenyl(C₁-C₄)alkylsulphonyl, a hydroxyl and an amino, with the proviso that when R⁵ ₃₂ is hydroxyl or amino, R⁵ ₃₂ is not bonded to a carbon atom carrying a heteroatom;

[0320] R₃₂ ⁶ is hydrogen or (C₁-C₁₂)alkyl unsubstituted or substituted with one or more groups (C₁-C₆)alkyl, aryl(C₁-C₃) alkyl, (C₁l-C₄) alkyloxycarbonyl, an aryl(C₁-C₄)alkyloxycarbonyl, a (C₁-C₄)alkyl-aminocarbonyl, an aryl (C₁-C₄) alkylaminocarbonyl, a (C₂-C₅) alkoxy, an oxycarbonyl (C₂-C₅) alkyl, or an aminocarbonyl(C₂-C₅)alkyl;

[0321] R₃₂ ⁷ is hydrogen, an aryl, a (C₃-C₇)cycloalkyl, or a (C₁-C₁₂)alkyl unsubstituted or substituted with one or more (C₁-C₅)alkyl, (C₃-C₇) cycloalkyl, hydroxyl, hydroxycarbonyl, aminocarbonyl, oxo or aryl groups;

[0322] m₃₂ is an integer from 1 to 10;

[0323] n₃₂ is an integer from 0 to 9;

[0324] q₃₂ is an integer from 0 to 2;

[0325] p₃₂ is an integer from 1 to 6;

[0326] Z₃₂ is O, N, S;

[0327] or their pharmaceutically acceptable salts or their optical isomers, as described in EP 478362.

[0328] XXXIII—SC 54684 or One of its Derivatives of Formula:

[0329] in which:

[0330] R₃₃ ¹ is selected from the group consisting of a hydrogen, lower alkyl radicals, lower alkenyl radicals, hydrocarbon-containing aromatic radicals, hydrocarbon-containing alicyclic radicals, benzyl radicals, phenethyl radicals, it being possible for the said radicals to be substituted with a halogen, a lower alkoxy, a hydroxyl or a lower alkyl;

[0331] R₃₃ ² is selected from the group consisting of a hydrogen, lower alkyl radicals, lower alkenyl radicals, lower alkynyl radicals, hydrocarbon-containing aromatic radicals, hydrocarbon-containing alicyclic radicals, benzyl radicals, phenethyl radicals, it being possible for the said radicals to be substituted with a halogen, a lower alkoxy, a hydroxyl or a lower alkyl;

[0332] A₃₃ is selected from the group consisting of lower alkylene radicals, lower alkenylene radicals, lower alkynylene radicals, and alicyclic divalent radicals, the said radicals being optionally substituted with a hydroxyl, a lower alkoxy, a lower alkyl, a halogen, an alkoxycarbonylalkyl, an amino, an alkylamino, a dialkylamino, an acylamino, an alkylthio, a sulphonyl, or aromatic hydrocarbon-containing radicals optionally substituted with a halogen, nitro, lower alkoxy or lower alkyl;

[0333] W₃₃ is selected from the group consisting of hydrogen, lower alkyl radicals, lower alkenyl radicals, lower alkynyl radicals and alicyclic hydrocarbon radicals or hydrocarbon-containing aromatic radicals, the said radicals being optionally substituted with a hydroxyl, a lower alkoxy, a lower alkyl, a halogen, a nitro, an amino, an acyloxy, a phenyl or a naphthyl, it being possible for the phenyl and naphthyl groups to be optionally substituted with a halogen, a nitro, a lower alkoxy or a lower alkyl;

[0334] Z₃₃, Z′₃₃ and Z″₃ are independently selected from the group consisting of hydrogen, lower alkyl radicals, halogen, alkoxy, cyano, sulphonyl, carboxyl, alkoxycarbonyl, and hydroxyl radicals;

[0335] q₃₃ is an integer between 0 and 6; and

[0336] with the proviso that when A₃₃ is a trimethylene and q₃₃ is 0, then R₃₃ ² cannot be hydrogen, a methyl radical or a phenyl radical, and also that when A₃₃ is a trimethylene, and q₃₃ is 1, then R₃₃ ² cannot be a hydrogen, as described in WO 93/07867.

[0337] XXXIV—SC 58053 or One of its Analogues of Formula:

[0338] or one of its pharmaceutically acceptable salts, in which

[0339] Z¹ ₃₄ and Z² ₃₄ are independently selected from the group consisting of (C₁-C₆)alkyl, hydroxyl, halogen or (C₁-C₆)alkoxy;

[0340] R¹ ₃₄ is selected from the group consisting of hydrogen, lower(C₁-C₆)alkyl, lower(C₂-C₆)alkenyl, lower(C₂-C₆)alkynyl, alkyloxycarbonyloxyalkyl, (C₃-C₆) cycloalkyl and aryl optionally substituted with a hydroxyl, a lower(C₁-C₆)alkoxy, a lower(C₁-C₆)alkyl, a halogen, nitro, amino, acyloxy, phenyl or naphthyl;

[0341] R² ₃₄ is selected from the group consisting of a hydrogen, a lower(C₁-C₆)alkyl, a lower(C₂-C₆)alkenyl, a lower(C₂-C₆)alkynyl, a cycloalkyl, an aryl, monocyclic, bicyclic or tricyclic heterocyclic radicals comprising 1 to 3 heteroatoms independently selected from oxygen, nitrogen and sulphur, the said radicals being optionally substituted with one or more radicals selected from the group consisting of a hydroxyl, a lower(C₁-C₆)alkoxy, a lower(C₁-C₆)alkyl, a halogen, nitro, cyano, azido, ureido, ureylene, carboxyl, carbonyl derivatives, trifluoromethyl, acyloxy, alkylthio, arylthio, alkylsulphinyl, arylsulphinyl, alkylsulphonyl, arylsulphonyl, amino, alkylamino, trialkylsilyl, aminosulphonyl, dialkylamino, alkanoylamino, aroylamino, phenyl and naphthyl;

[0342] R³ ₃₄ is selected from the group consisting of hydrogen, (C₁-C₆)alkyl, (C₁-C₆)alkoxy, halogen, amino, monoalkylamino-, dialkylamino, acylamino, alkylsulphonylamino, arylsulphonylamino, hydroxyl, alkoxycarbonyl and alkoxycarbonylalkyl;

[0343] X₃₄ is selected from the group consisting of

[0344] m₃₄ is an integer from 1 to 4;

[0345] n₃₄ is an integer from 0 to 4; and

[0346] p₃₄ is 0 or 1 in which n₃₄ and p₃₄ are not both equal to 0; as described in WO 94/22820.

[0347] XXXV—GR 144053 or One of its Analogues of Formula:

[0348] in which

[0349] X¹ ₃₅ and Y¹ ₅ which are identical or different, represent CH or N;

[0350] X² ₃₅ represents CH, but when X¹ ₃₅ represents CH, it may also represent N;

[0351] Y² ₃₅ represents N, but when Y¹ ₃₅ represents N, it may also represent CH;

[0352] Z₃₅ represents N or N⁴R⁵ ₃₅;

[0353] R¹ ₃₅ represents a hydrogen atom or a hydroxyl, a (C₁-C₄)alkyl or a 2,2,2-trifluoroethyl group;

[0354] R² ₃₅ represents a hydrogen atom but when X¹ ₃₅ and X² ₃₅ both represent CH, it may also represent a fluorine, chlorine or bromine atom or a (C₁-C₄) alkyl group;

[0355] R³ ₃₅ represents a hydrogen atom, but when Y¹ ₃₅ and Y² ₃₅ both represent N, it may also represent a (C₁-C₄)alkyl group or a hydroxymethyl group;

[0356] R⁴ ₃₅ represents a hydrogen atom, or when Z₃₅ represents N, R⁴ ₃₅ represent as it may a (C₁-C₄)alkyl group;

[0357] R⁵ ₃₅ represents a (C₁-C₄)alkyl group or a phenyl group;

[0358] R⁶ ₃₅ represents a hydrogen atom or a (C₁-C₄)alkyl group;

[0359] as well as its pharmaceutically acceptable derivatives, salts and solvates, as described in EP 542363.

[0360] XXXVI—BIBU 104 and its Analogues of Formula:

B₃₆—X₃₆-A₃₆-Y₃₆-E₃₆   (XXXVI)

[0361] in which:

[0362] A₃₆ represents a 4- to 7-membered iminocyclic alkylene group optionally substituted with R₃₆ ¹, R₃₆ ² and R₃₆ ³ groups, in which an ethylene group may be substituted with an ethenylene group or a methylene group may be substituted with a carbonyl group;

[0363] R₃₆ ¹ represents an aryl group or an optionally mono- or polyunsaturated, alkyl group of 1 to 6 carbon atoms, which may be substituted with one or two aryl groups, with a cycloalkyl, alkylthio, alkylsulphinyl, alkylsulphonyl, alkylcarbonyl, aralkylcarbonyl, arylcarbonyl, R₃₆ ⁴—O—CO— or (R₃₆ ⁵)₂NCO— group or a group R₃₆ ⁶CO or with a bi- or tricyclic aryl group, which may be completely or partially hydrogenated, it being understood that the unsaturated alkyl group cannot be directly linked to the endocyclic nitrogen atom of the radical A₃₆ by a triple bond and that a double bond can only be linked to the endocyclic nitrogen atom when a carbonyl group is contiguous to the double bond, or as long as R₃₆ ¹ is not attached to the nitrogen atom of the radical A₃₆ when A₃₆ represents a lactam ring, R₃₆ ¹ represents a carbonyl group, which is substituted with an alkyl, aralkyl, aryl, (R₃₆ ⁵)₂N, R₃₆ ⁴OCO, (R₃₆ ⁵)₂NCO, alkoxy, aralkoxy, alkylcarbonyl-NR₃₆ ⁵-alkyl, aralkylcarbonyl-NR₃₆ ⁵-alkyl, arylcarbonyl-NR₃₆ ⁵-alkyl, R₃₆ ⁴O-alkyl, (R₃₆ ⁵)₂N-alkyl, alkyl-SO₂—NR₃₆ ⁵-alkyl, aralkyl-SO₂—NR₃₆ ⁵-alkyl or aryl-SO₂—NR₃₆ ⁵-alkyl group;

[0364] a (C₁-C₆)alkyl group, substituted with R₃₆ ⁶, with one or two hydroxyl groups, with an alkoxy, aryloxy, aralkoxy, arylthio, aralkylthio, arylsulphinyl, aralkylsulphinyl, arylsulphonyl, aralkylsulphonyl, N(R₃₆ ⁵ )₂-sulphonyl, R₃₆ ⁶-sulphonyl, (R₃₆ ⁵⁾ ₂N, alkylcarbonyl-N₃₆ ⁵, arylcarbonyl-NR₃₆ ⁵, aralkylcarbonyl-NR₃₆ ⁵, alkylsulphonyl-NR₃₆ ⁵, arylsulphonyl-NR₃₆ ⁵, aralkylsulphonyl-NR₃₆ ⁵, (R₃₆ ⁵)₂N—CO—NR₃₆ ⁵— group or a group (R₃₆ ⁵)₂N—SO₂—NR₃₆ ⁵, it being understood that when R₃₆ ¹ is linked to the endocyclic nitrogen atom of the radical A₃₆, the substituents of the alkyl group are present only from the 2-position onwards,

[0365] or when the radical R₃₆ ¹ is not linked to a carbon atom adjacent to the endocyclic nitrogen atom and when the radical R₃₆ ¹ is not linked to an unsaturated carbon atom of the radical A₃₆, R₃₆ ¹ may also represent a hydroxyl, alkylcarbonyl-NR₃₆ ⁵, arylcarbonyl-NR₃₆ ⁵, aralkylcarbonyl-NR₃₆ ⁵, alkylsulphonyl-NR₃₆ ⁵, arylsulphonyl-NR₃₆ ⁵, aralkylsulphonyl-NR₃₆ ⁵, (R₃₆ ⁵)₂N—CO—NR₃₆ ⁵ or (R₃₆ ⁵)₂N—SO₂NR₃₆ ⁵ group,

[0366] or as long as R₃₆ ¹ is not linked to the nitrogen atom of the radical A₃₆, when A₃₆ represents a lactam ring and is not linked to the carbon atom adjacent to the nitrogen atom, R₃₆ ¹ may also represent an alkylsulphonyl, arylsulphonyl, aralkylsulphonyl or (R₃₆ ⁵)₂N—SO₂ group, or when the radical R₃₆ ¹ is not linked to the endocyclic atom of the radical A₃₆ or to a carbon atom adjacent to the endocyclic nitrogen atom of the radical A₃₆ or to an unsaturated carbon atom of the radical A₃₆, R₃₆ ¹ may represent an alkoxy, aryloxy, aralkoxy, alkylthio, arylthio, aralkylthio, alkylsulphinyl, arylsulphinyl or aralkylsulphinyl group,

[0367] or when R₃₆ ¹ is not linked to the endocyclic nitrogen atom of the radical A₃₆, R₃₆ ¹ may represent a carboxyl groups

[0368] in which,

[0369] R₃₆ ⁴ and R₃₆ ⁵, which are identical or different, represent a hydrogen atom, an alkyl, aralkyl, aryl or alkoxyalkyl group, it being understood that the alkoxy group cannot be present on the same carbon atom as the carbonyloxy or carbonylamino group, and

[0370] R₃₆ ⁶ is a 5- to 7-membered alkylenimino group linked by the nitrogen, in which a methylene group at the 3-position or at the 4-position may be replaced with an S, a sulphinyl, sulphonyl, imino, alkylimino, aralkylimino, arylimino, formylimino, alkanoylimino, aralkanoylimino, arylcarbonylimino, (R₃₆ ⁶)₂N-carbonylimino, alkylsulphonylimino, aralkylsulphonylimino or arylsulphonylimino, or an (R₃₆ ⁵)₂N-sulphonylimino group, and when R₃₆ ⁶ is not linked to a carbonyl group or to a sulphonyl group, the said methylene group can also be replaced at the 2-position by a carbonyl group or at the 4-position by a sulphur atom, it being understood that R₃₆ ⁵ is as defined above and, that the alkanoyl portion contains from 1 to 4 carbon atoms,

[0371] R₃₆ ² and R₃₆ ³, which are identical or different, represent alkyl, aryl or aralkyl,

[0372] B₃₆ represents a cyano group or a nitro group, an amino group or an aminoalkyl of 1 to 6 carbon atoms optionally substituted on the nitrogen atom with one or two alkyl groups of 1 to 5 carbon atoms or with an aralkyl group, an amidino, guanidino, amidinoalkyl or guanidinoalkyl group optionally substituted with 1, 2 or 3(C₁-C₅)alkyl groups or with an aralkyl group, in which the alkyl portion contains each time from 1 to 6 carbon atoms and in which two nitrogen atoms of an amidino group or of a guanidino group may also form together an alkylene chain of 2 to 4 carbon atoms, it being understood that a nitrogen atom in the above-mentioned groups may also be substituted with a cyano, hydroxyl, alkoxy, amino, arylcarbonyl, aryloxycarbonyl, or aralkoxycarbonyl group or with an alkoxycarbonyl group of 2 to 6 carbon atoms as long as it does not exist in the form of an ammonium, or an ammonium or aminoalkyl group of 1 to 6 carbon atoms substituted with 3 alkyl groups of 1 to 3 carbon atoms,

[0373] E₃₆, which is linked to a carbon atom of the group Y₃₆ or of the group A₃₆ and which has at the very minimum between itself and the first nitrogen atom of B₃₆ at least 10 bonds, is a vinyl, a hydroxymethyl, a bis(hydroxycarbonyl)methyl, a bis (alkoxycarbonyl)-methyl, a CN, a sulpho, a phosphono, an O-alkylphosphono or a 5-tetrazolyl, a carbonyl (substituted with a (C₁-C₇)alkoxy, with NH₂, OH, aralkoxy, heteroarylalkoxy, aminoalkoxy or with an aminocarbonylalkoxy, in which the amino groups are themselves optionally mono- or disubstituted with alkyl, aryl or aralkyl, or an alkyleneiminoalkoxy containing from 5 to 7 members (in which one of the CH₂ groups of the 5- to 7-membered alkylenimino ring is optionally replaced by a carbonyl, it being also possible for a group at the 4-position to be replaced by an oxygen atom, a sulphur atom, SO, imino, alkylimino, aralkylimino or arylimino, or at the 2- or 4-position by an SO₂), with the proviso that if B₃₆ is linked via a nitrogen atom to an aryl group of X₃₆, E₃₆ cannot be a vinyl linked by a methylene to the cyclic nitrogen of A₃₆ if A₃₆ is a pyrrolidine;

[0374] X₃₆ is a group of formula —X₃₆ ¹—X₃₆ ²—X₃₆ ³—X₃₆ ⁴—X₃₆ ⁵— in which

[0375] X₃₆ ¹ is bonded to the radical A₃₆ and X₃₆ ⁵ is bonded to the radical B₃₆, and represents a bond, an optionally mono- or polyunsaturated alkylene group, or an optionally mono- or polyunsaturated arylene group, it being understood that between the alkylene group and the adjacent group X₃₆ ², there may also be in addition an oxygen atom or a sulphur atom or an SO, SO₂, NR⁷ ₃₆, CO, CO—NR⁸ ₃₆, NR⁸ ₃₆—CO, SO₂—NR⁸ ₃₆, NR⁸ ₃₆—SO₂, NR⁸ ₃₆—CO—NR⁸ ₃₆ or NR⁸ ₃₆—SO₂—NR⁸ ₃₆ group,

[0376] or alternatively when the radical X₃₆ ¹ is not linked to the endocyclic nitrogen atom of the radical A₃₆, when A₃₆ represents a lactam ring, X₃₆ ¹ represents a carbonyl, alkylenecarbonyl, CONR⁸ ₃₆ or CO—O group and, in the case where the group X₃₆ ¹ is not bonded to a carbon atom adjacent to the endocyclic nitrogen atom or to the endocyclic nitrogen atom of the radical A₃₆, when A₃₆ represents a lactam ring, X₃₆ ¹ represents an SO₂ group or an SO₂—NR⁸ ₃₆ group,

[0377] or when the radical X₃₆ ¹ is not linked to a carbon tom adjacent to the endocyclic nitrogen atom of the radical A₃₆, X₃₆ ¹ may also represent an oxygen atom, an NR⁷ ₃₆, NR⁸ ₃₆—CO or NR⁸ ₃₆—SO₂ group,

[0378] or when the group X₃₆ ¹ is not linked to the endocyclic nitrogen atom or to the carbon atom adjacent to the endocyclic nitrogen atom of the radical A₃₆, X₃₆ ¹ may also represent a sulphur atom or a sulphinyl group, it being understood that

[0379] R₃₆ ⁷ represents a hydrogen atom, an alkyl, aralkyl, aryl, alkylcarbonyl, aralkylcarbonyl, arylcarbonyl, alkylsulphonyl, arylsulphonyl, aralkylsulphonyl, aminocarbonyl or aminosulphonyl group, it being possible for the abovementioned amino groups to be mono- or disubstituted with identical or different substituents selected from the alkyl, aralkyl or aryl groups, and R₃₆ ⁸ represents a hydrogen atom, an alkyl, aryl or aralkyl group,

[0380] X₃₆ ² represents a fluorenylene ring whose methylene group may be replaced by a carbonyl or hydroxymethylene group, or an arylene ring, in which two carbon atoms adjacent to the arylene ring may be optionally attached by a propylene, propenylene, butylene, butenylene, butadienylene, pentylene, pentenylene or pentadienylene bridge, a naphthalene ring completely or partially hydrogenated on the two rings or a tricyclic arylene ring optionally completely or partially hydrogenated, it being understood that in these cyclic systems, a methylene group may be replaced by a carbonyl or hydroxymethylene group,

[0381] an optionally mono- or polyunsaturated cycloalkylene group, an optionally mono- or polyunsaturated bicycloalkylene group of 6 to 12 carbon atoms or an optionally mono- or polyunsaturated spiroalkylene group of 8 to 12 carbon atoms, which may further carry 1 to 3 alkyl substituents,

[0382] an alkylene group of 1 to 8 carbon atoms, which may be mono- or polyunsaturated, it being understood, however, that a double bond or a triple bond is not adjacent to a heteroatom,

[0383] X₃₆ ³ represents a bond, an alkylene group of 1 to 7 carbon atoms, which may be mono- or polyunsaturated, it being understood that a double or triple bond cannot be adjacent to a triple bond of the radical X₃₆ ², or a hydroxyalkylene group,

[0384] or when X₃₆ ³ is not immediately after an optionally substituted amino group, a trialkylammonium group or a nitro group or after a triple bond of the radical B₃₆, X₃₆ ³ may also represent a CO, CONR⁸ ₃₆ or NR⁸ ₃₆CO group, it being understood that the latter is not directly bonded to an aliphatic double or triple bond of the radical X₃₆ ²,

[0385] or when X₃₆ ³ is not immediately after a heteroatom or an unsaturated carbon atom of the radical B₃₆, X₃₆ ³ may also represent an SO₂ group,

[0386] or alternatively when X₃₆ ² does not contain an aliphatic double or triple bond at its end, and when X₃₆ ³ does not immediately follow a heteroatom or an unsaturated carbon atom of the radical B₃₆, X₃₆ ³ may also represent an oxygen atom or a sulphur atom, an SO, NR⁷ ₃₆, NR⁸ ₃₆SO₂ or SO₂NR⁸ ₃₆ group, it being understood that R⁷ ₃₆ and R⁸ ₃₆ are as defined above,

[0387] X₃₆ ⁴ represents a bond, an arylene group, in which two adjacent carbon atoms may be linked by a propylene, propenylene, butylene, butenylene, butadienylene, pentylene, pentenylene or pentadienylene bridge, a cycloalkylene group or a bicycloalkylene group of 6 to 12 carbon atoms and

[0388] X₃₆ ⁶ represents a bond, an alkylene group, which may be mono- or polyunsaturated, it being understood that a double or triple bond cannot be bonded to a heteroatom of the radical B₃₆ or of the radical X₃₆ ³ or to a terminal triple bond of the radical X₃₆ ³, if X₃₆ ⁴ represents a bond,

[0389] a CO-alkylene group or if X₃₆ ⁶ is not immediately after an optionally alkylated amino group, a trialkylammonium group or a nitro group or after a triple bond of the radical B₃₆, then X₃₆ ⁵ may also represent CO, CONR⁸ ₃₆ or NR⁸ ₃₆—CO, it being understood that the latter is not directly bonded to an oxygen atom or a sulphur atom or to a carbonyl group of the radical X₃₆ ³ or to a double or a triple bond,

[0390] or alternatively when the alkylene group of the radical B₃₆ follows X₃₆ ⁵ and that X₃₆ ⁵ is not immediately adjacent to an oxygen atom or to a sulphur atom or to a carbonyl group of the radical X₃₆ ³ or to a double or triple bond, X₃₆ ⁵ may also represent an NR⁸ ₃₆—SO₂, SO₂NR⁸ ₃₆ or SO₂ group,

[0391] or when X₃₆ ⁵ is not immediately adjacent to a heteroatom or to a CO group of the radical X₃₆ ³ or to a double or triple bond, X₃₆ ⁵ may also represent an O-alkylene, S-alkylene or SO-alkylene group, it being understood that a heteroatom of the radical B₃₆ is not present on the same carbon atom as an oxygen atom, a sulphur atom or an SO group and that the radicals R⁷ ₃₆ and R⁸ ₃₆ are as defined above and

[0392] Y₃₆ is a group of formula:

—Y₃₆ ¹—Y₃₆ ²—Y₃₆ ³—, in which

[0393] Y₃₆ ¹ is bonded to the group A₃₆ and Y₃₆ ³ is bonded to the group E₃₆ and Y₃₆ ¹ represents a bond, an alkylene group, which may be mono- or polyunsaturated, it being understood, however, that a triple bond of the alkyl group is not directly bonded to the endocyclic nitrogen atom of the radical A₃₆ and that a double bond may be bonded to the endocyclic nitrogen atom only if it is followed by a carbonyl group, a hydroxyalkylene group in which the hydroxyl group is not carried by the carbon atom which is bonded to the endocyclic nitrogen of the radical A₃₆ if Y₃₆ ¹ is linked to the endocyclic nitrogen, a CO group or a CO—NR⁸ ₃₆ group, as long as they are not directly bonded to the endocyclic nitrogen atom of the radical A₃₆ when the latter represents a lactam ring,

[0394] or when Y₃₆ ¹ is not linked to a carbon atom adjacent to the endocyclic nitrogen atom of the radical A₃₆ and is not on the endocyclic nitrogen atom of the radical A₃₆, when A₃₆ represents a lactam ring, Y₃₆ ¹ also represents an SO₂ group or an SO₂—NR⁸ ₃₆ group,

[0395] or when Y₃₆ ¹ is not linked to the endocyclic nitrogen atom or to a carbon atom adjacent to the endocyclic nitrogen atom or to an unsaturated carbon atom of the radical A₃₆, Y₃₆ ¹ may also represent an oxygen atom, a sulphur atom or an SO, NR⁷ ₃₆ or NR⁸ ₃₆—SO₂ group, it being understood that R⁷ ₃₆ and R⁸ ₃₆ are as defined above, Y₃₆ ² represents a bond, an alkylene group, which may be mono- or polyunsaturated, it being understood, however, that a double bond or a triple bond cannot be adjacent to a heteroatom or to a triple bond of the radical Y₃₆ ¹, an arylene group,

[0396] or when Y₃₆ ¹ does not end with an oxygen atom or a sulphur atom or a triple bond or a CO group, Y₃₆ ² represents CO, SO₂ or CONR⁸ ₃₆,

[0397] or when Y₃₆ ¹ does not end with an oxygen atom, a sulphur atom or a sulphinyl group or a double or triple bond, Y₃₆ ² represents an NR⁷ ₃₆ group,

[0398] or when Y₃₆ ¹ does not end with a heteroatom, a double or triple bond or a CO group, Y₃₆ ² represents an oxygen atom, a sulphur atom or an SO group or an O—CO group, or alternatively when Y₃₆ ¹ does not end with a double or triple bond, with an oxygen atom or with a sulphur atom or with a CO group, Y₃₆ ² represents an NR⁸ ₃₆—SO₂ or SO₂₋NR⁸ ₃₆ group, it being understood that R⁷ ₃₆ and R⁸ ₃₆ are as defined above,

[0399] Y₃₆ ³ represents a bond, an arylene, alkylene-arylene, alkylenoxy-arylene, alkylenesulphenyl-arylene, alkylenesulphinyl-arylene, alkylenesulphonyl-arylene, alkylene-NR⁸ ₃₆-arylene, alkylene-N(alkylcarbonyl)-arylene, alkylene-N(aralkylcarbonyl)arylene, alkylene-N(arylcarbonyl)-arylene, alkylene-NR⁸ ₃₆-carbonyl-arylene, alkylenecarbonyl-NR⁸ ₃₆-arylene, bisarylene, alkylene-bisarylene or alkylenoxy-bisarylene group, it being understood that R⁸ ₃₆ is as defined above, or alternatively when Y₃₆ ¹ and Y₃₆ ² each represent a bond, Y₃₆ ³ may represent hydroxyalkylene, N(R⁵ ₃₆)₂-alkylene, alkylcarbonyl-NR⁸ ₃₆-alkylene, aralkylcarbonyl-NR⁸ ₃₆-alkylene, arylcarbonyl-NR⁸ ₃₆-alkylene, alkylsulphonyl-NR⁸ ₃₆-alkylene or arylsulphonyl-NR⁸ ₃₆-alkylene, it being understood that when Y₃₆ is linked to the endocyclic nitrogen atom of the radical A₃₆, a hydroxyl, NR⁸ ₃₆ or N(R⁵ ₃₆)₂ group is not linked to the carbon atom of the radical A₃₆ bonded to the endocyclic nitrogen atom and it being understood that R₃₆ ⁵ and R⁸ ₃₆ are as defined above,

[0400] the alkylene, alkyl, alkoxy, cycloalkyl, cycloalkylene, aryl and arylene groups being as defined in application EF 483 667, it being understood that aryl and arylene groups are understood to mean mono-, bi- or tricyclic aromatic groups, which may be monosubstituted with an aryl, aralkyl or nitro group and/or which may be mono-, di- or trisubstituted with a fluorine, chlorine or bromine atom, with an alkyl group of 1 to 5 carbon atoms, with a hydroxyl, alkoxy, aralkoxy, trifluoromethyl, mercapto, alkylthio, alkylsulphinyl, alkylsulphonyl, amino, alkylamino, dialkylamino, alkylcarbonylamino, aralkylcarbonylamino, arylcarbonylamino, alkoxycarbonylamino, alkylsulphonylamino, arylsulphonylamino, N-alkylcarbonylalkylamino, N-aralkylcarbonylalkylamino, N-arylcarbonylalkylamino, N-alkoxycarbonylalkylamino, N-alkylulphonylalkylamino, N-arylsulphonylalkylamino, cyano, aminocarbonyl, alkylaminacarbonyl, dialkylaminocarbonyl, aminosulphonyl, alkylaminosulphonyl, dialkylaminosulphonyl, alkylcarbonyl, aralkylcarbonyl, arylcarbonyl, carboxyl, sulpho, alkoxycarbonyl, aminocarbonylamino, N-aminocarbonylalkylamino or aminoalkyl, the substituents being identical or different and it being possible for the amino groups of the abovementioned aminocarbonylamino, N-aminocarbonylalkylamino or aminoalkyl groups to be, in addition, mono- or disubstituted with an alkyl or aralkyl group,

[0401] their geometric isomers and the addition salts, as described in EP 483 667.

[0402] XXXVII—BIBU 129 or a Cyclic Urea Derivative of Formula:

[0403] in which

[0404] X₃₇ is a carbimino optionally substituted with alkyl, aralkyl, aryl, heteroaryl, or cyano, CO, CS, SO or SO₂;

[0405] Y₃₇ is

[0406] (a) a straight (C₂-C₄)alkylene, or an alkenylene optionally substituted with R^(c) ₃₇ and/or R^(d) ₃₇, and in which each carbon atom is substituted with one or two identical or different substituents selected from F, Cl, Br, alkyl, CF₃, aralkyl, aryl, heteroaryl and alkylcarbonyl, and in which also one or two CH₂ may be replaced by CO;

[0407] (b) 1,2-(C₄-C₇)cycloalkylene optionally substituted with R^(c) ₃₇ and/or R^(d) ₃₇;

[0408] (c) 1,2-(C₄-C₇)cycloalkenylene;

[0409] (d) 1,2-phenylene in which 1 or 2 CH are optionally substituted with N or 1 or 2 CH═CH with a CONR¹ ₃₇, the said 1,2-phenylene being optionally substituted on its carbon backbone with F, Cl, Br, (C₁-C₄)alkyl, CF₃, OH, alkoxy, alkylthio, alkylsulphinyl, alkylsulphonyl, alkylcarbonyl, arylcarbonyl, alkoxycarbonyl, COOH, NO₂, (R¹ ₃₇)₂N, (R¹ ₃₇)₂NCO, (R¹ ₃₇)₂NSO₂, or with R¹ ₃₇NH (it being possible for —R₃₇ ¹ itself to be substituted with an alkylcarbonyl, arylcarbonyl, aralkylcarbonyl, heteroatylcarbonyl, alkylsulphonyl, aralkylsulphonyl, or arylsulphonyl)

[0410] R¹ ₃₇ is a hydrogen atom, an alkyl, an aralkyl, an aryl or a heteroaryl;

[0411] or Y₃₇ is

[0412] (e) CONH, NHCO, CH═N or N═CH, optionally substituted with R^(c) ₃₇ or R^(d) ₃₇; a radical from R⁴ ₃₇ to R^(d) ₃₇ is A₃₇-B₃₇—C₃₇— in which:

[0413] A₃₇ is a (C₁-C₅) aminoalkyl, NH₂, amidino, guanidino (for each of these groups, one or two hydrogen atoms bonded to a nitrogen atom may be replaced with a (C₁-C₄)alkyl or a hydrogen atom bonded to a nitrogen may be replaced with a (C₂-C₅)alkoxycarbonyl, alkylcarbonyl, arylcarbonyl, aryloxycarbonyl or aralkylcarbonyl); CN, cyano(C₁-C₄)alkyl; or provided that A₃₇ is linked to an N atom of B₃₇ or C₃₇ not forming part of a lactam ring, then A₃₇ may also represent H or alkyl;

[0414] B₃₇ is a bond, an alkylene, or an alkenylene; a phenylene (optionally substituted with one or two identical or different substituents selected from F, Cl, Br, (C₁-C₄)alkyl, CF₃, OH, alkoxy, alkylthio, alkylsulphinyl, alkylsulphonyl, (R¹ ₃₇)₂N, (R¹ ₃₇)₂NCO, (R¹ ₃₇)₂NSO₂, NO₂ or R¹ ₃₇NH, it being possible for the latter to be substituted as defined above;

[0415] a pyridinylene, pyrimidinylene, pyrazinylene, pyridazylene or triazinylene ring (all optionally substituted on the carbon-containing backbone with an alkyl; it being possible for one or two —CH═N— groups of these rings to be replaced with CONR¹ ₃₇, it being possible for a nitrogen atom to be attached to the radical C₃₇ instead of R₃₇ ¹ as long as the latter is not bonded to a heteroatom or to a carbonyl group of the radical B₃₇),

[0416] a cyclopropylene, (optionally substituted with an alkyl, aralkyl or aryl);

[0417] (C₄-C₅) cycloalkylene (optionally substituted like cyclopropylene and it being possible for a CH of the cycloalkylene to be replaced with a nitrogen atom, it being possible for a CH₂ adjacent to the nitrogen atom to be replaced in addition with CO);

[0418] a (C₆-C₇)cycloalkylene (optionally substituted like the cyclopropylene and in which 1 or 2 CH (at the 1-4 position) may be replaced with a nitrogen atom, it being possible for a CH₂ adjacent to the nitrogen atom to be in addition replaced with a carbonyl group);

[0419] or a biphenylene (optionally substituted with one or two F, Cl, Br, alkyl, CF₃, OH, alkoxy, alkylthio, alkylsulphinyl, alkylsulphonyl, alkylcarbonyl-NR₃₇ ¹ or alkylsulphonyl-NR¹ ₃₇);

[0420] C₃₇ is an alkylene or an alkenylene (optionally substituted with OH, alkoxy or N(R¹ ₃₇)₂); alkylenecarbonyl (bonded to B₃₇ via the CO); a phenylene. (optionally substituted like for B₃₇); indanylene, or 1,2,3,4-tetrahydronaphthylene (saturated ring linked to A₃₇, the aromatic ring being linked to the carbamide portion); pyridinylene, pyrimidinylene, pyrazinylene, pyridazinylene or triazinylene (all optionally substituted on the carbon-containing backbone with an alkyl; it being possible for one or two —CH═N— groups of these rings to be replaced with a —CO—NR₃₇ ¹ group, and it being possible for a nitrogen atom to be attached to the B₃₇ radical instead of R₃₇ ¹ as long as the latter does not represent a bond or is not bonded to a heteroatom of the radical C₃₇); or (C₄-C₅)cycloalkylene, as defined for B₃₇;

[0421] a second radical selected from R^(a) ₃₇ to R^(d) ₃₇ represents a group of formula F₃₇-E₃₇-D₃₇-, in which

[0422] D₃₇ is a (C₁-C₅)alkylene or a (C₂-C₅)alkenylene; a phenylene (optionally mono- or disubstituted with one or more identical or different substituents selected from F, Cl, Br, (C₁-C₄)alkyl, CF₃, OH, alkoxy, alkylthio, alkyl-SO—, alkyl-SO₂—, carboxyalkoxy, alkoxycarbonylalkoxy, aralkoxycarbonylalkoxy, (R¹ ₃₇)₂N—, (R¹ ₃₇)₂NCO—, (R¹ ₃₇)₂NSO₂ or NO₂ or R¹ ₃₇NH— (R¹ ₃₇NH— being optionally substituted as indicated above); a pyridinylene, pyrimidinylene, pyrazinylene, pyridazinylene or triazinylene ring (all optionally substituted on the carbon-containing backbone with an alkyl; it being possible for one or two —CH═N— groups of these rings to be replaced with a —CO—NR₃₇ ¹ group, and it being possible for a nitrogen atom to be attached to the radical E₃₇ instead of R¹ ₃₇ as long as the latter does not represent a bond or is (not bonded to a heteroatom of the radical D₃₇); (C₄₋C₅) cycloalkylene as defined above for B₃₇;

[0423] a (C₄-C₅) cycloalkylene as defined above for B₃₇, a (C₆-C₇)cycloalkylene as defined above for B₃₇, or a (C₂-C₆)alkylene group interrupted by the radical W in which W represents O, S, SO, SO, R₃₇ ¹N—, (alkylcarbonyl)N—, (aralkylcarbonyl)N—, (arylcarbonyl)N—, (heteroarylcarbonyl)N—, (alkylsulphonyl)N—, (arylsulphonyl)N—, aminocarbonyl- or carbonylamino;

[0424] E₃₇ is a bond, a (C₁-C₅) alkylene, or a (C₂-C₅)alkenylene (optionally substituted with one or two alkyl, or with an OR, alkoxy, NH₂, alkylamino, aralkylamino, dialkylamino, bis(aralkyl)amino, a carboxyalkyl, an alkoxycarbonylalkyl or an aralkoxycarbonylalkyl);

[0425] a phenylene (optionally substituted like for B₃₇);

[0426] a pyridinylene, pyrimidinylene, pyrazinylene, pyridazylene or triazinylene ring (all optionally substituted on the carbon-containing backbone with an alkyl; it being possible for one or two —CH═N— groups to be replaced by a CO—NR₃₇ ¹ group and it being possible for a nitrogen atom to be bonded to the D₃₇ radical instead of the R₃₇ ¹ radical), a (C₄-C₅)cycloalkylene group as defined for D₃₇; a (C₆-C₇)cycloalkylene group as defined for D₃₇; an alkylenearylene (aryl linked to D₃₇); or an alkylene linked to W₃₇ of D₃₇;

[0427] F₃₇ is a carbonyl group substituted with OH or (C₁-C₆)alkoxy (it being possible for a (C₁-C₃)alkoxy to be substituted on each of its positions with an aryl or a heteroaryl, or at the, 2- or 3-position with a pyrrolidin-2-on-1-yl, morpholino, thiomorpholino or 1-oxido-thiomorpholino); sulpho phosphono; O-alkylphosphono or tetrazol-5-yl; it being understood that when A₃₇=CN or an amino or an aminoalkyl (the amino and aminoalkyl radicals being optionally benzoylated or benzyloxycarbonylated on the nitrogen atom), the shortest distance between the nitrogen atom of these groups and F₃₇ being at least 10 bonds;

[0428] a third radical selected from R⁴ ₃₇ to R^(d) ₃₇ is H, alkyl, perfluoroalkyl, aralkyl, aryl or heteroaryl, it being understood that this third radical, when it is linked to an unsaturated carbon atom of Y₃₇, may also be an alkoxy, an alkylthio or (R¹ ₃₇)₂N;

[0429] a fourth radical selected from R^(e) ₃₇ to R^(d) ₃₇ is H, an alkyl, an aralkyl, an aryl or a heteroaryl; or R^(a) ₃₇ or R^(b) ₃₇ together with adjacent R^(c) ₃₇ or R^(d) ₃₇ represent a bond;

[0430] it should be understood that unless otherwise defined (a) all the alkyl, alkylene, alkenylene or alkoxy have from 1 to 3 carbon atoms;

[0431] (b) aryl is phenyl (optionally substituted with a CF₃, COOH, (R¹ ₃₇)₂NCO, alkoxycarbonyl, alkylcarbonyl, alkylthio, alkylsulphinyl, alkylsulphonyl, NO₂, (R¹ ₃₇)₂N, alkylcarbonyl-NR₃₇ ³, aralkylcarbonyl-NR₃₇ ³—; aryl-carbonyl-NR₃₇ ³—, heteroarylcarbonyl-NR₃₇ ³—, alkylsulphonyl-NR₃₇ ³, aralkylsulphonyl-NR₃₇ ³, arylsulphonyl-NR₃₇ ³, or (R₃₇ ³)₂N-sulphonyl; or with 1 to 3 F, Cl, Br, OH or a (C₁-C₄) alkyl or alkoxy);

[0432] the heteroaryl is a 5-membered heteroaromatic ring with an oxygen atom, a sulphur atom or a nitrogen atom, a nitrogen atom and an oxygen atom, a sulphur atom or a nitrogen atom or two nitrogen atoms and an oxygen atom, a sulphur atom or a nitrogen atom, or a 6-membered heteroaromatic ring with one, two or three nitrogen atoms, and in which one or two —CH═N— groups may be replaced with a —CO—NR₃₇ ³ group, it being understood that the said heteroaromatic rings may be substituted with one or two alkyl groups or with a fluorine, chlorine or bromine atom or with a hydroxyl or alkoxy group),

[0433] and their tautomeric forms and their stereoisomers (or mixtures thereof) as well as their pharmaceutically acceptable salts as described in EP 503548.

[0434] XXXVIII—SR 121787A or One of its Analogs of Formula:

[0435] in which:

[0436] R₃₈ ¹ represents hydrogen, a (C₁-C₅)alkyl, a (C₃-C₈)cycloalkyl, an aralkyl in which the alkyl portion is a C₁-C₅, an alkoxycarbonylalkyl group in which the alkoxy and alkyl portions are a C₁-C₃ or a carboxyalkyl group in which the alkyl portion is a C₁-C₃;

[0437] A₃₈ represents either a methylene group optionally mono- or disubstituted with a (C₁-C₅)alkyl group; with an alkoxycarbonyl group in which the alkoxy portion is a C₁-C₅; with an alkoxycarbonylalkyl group in which the alkoxy and alkyl portions are a C₁-C₅; with a carboxyalkyl group in which the alkyl portion is a C₁-C₅; with a phenyl or benzyl group unsubstituted or substituted on the aromatic ring with a (C₁-C₅)alkyl, a (C₁-C₅)alkoxy, a hydroxyl, a halogen or a trifluoromethyl; with a pyridyl group; or an ethylene group;

[0438] R₃₈ represents hydrogen, or a (C₁-C₅)alkyl group; an aryl group or an aralkyl group in which the alkyl portion is a C₁-C₅ optionally substituted with a hydroxyl, a (C₁-C₃)alkoxy, a halogen, a trifluoromethyl or a (C₁-C₅)alkyl;

[0439] Y₃₈ represents hydrogen; a —COOR₃₈ ² group in which R₃₈ ² represents a (C₁-C₅)alkyl group, an aryl group or an aralkyl group in which the alkyl portion is a C₁-C₅ optionally substituted with a (C₁-C₅)alkyl; a —COR₃₈ ³ group in which the R₃₈ ³ represents a (C₁-C₅)alkyl; or one of their salts, as described in EP 719775.

[0440] XXXIX—FK 633 and its Peptide Analogues of Formula:

[0441] in which:

[0442] R₃₉ ¹ is a phenyl, naphthyl or anthryl group, in which each has 1 to 3 substituents selected from the group consisting of amidino and protected amidino groups,

[0443] R₃₉ ² is a carboxy(C₁-C₆ alkyl) or protected carboxy-(C₁-C₆ alkyl) group,

[0444] R₃₉ ³ is a carboxyl or protected carboxyl group,

[0445] A₃₉ ¹ is an alkylene group which may have 1 to 8 substituents selected from the group consisting of amino and protective amino groups,

[0446] A₃₉ ² is a group of formula:

[0447] in which R₃₉ ⁴ is a (C₁-C₆)alkyl group or a group of formula:

—NHCH₂CH₂CO—

[0448] A₃₉ ³ is a (C₁-C₆)alkylene group which may have 1 to 3 substituents selected from the group consisting of a (C₁-C₆)alkyl group; mono-(or di- or tri)phenyl(C₁-C₆) alkyl) group which may have 1 to 3 substituents selected from the group consisting of a hydroxyl, (C₁-C₆)alkoxy and protected hydroxyl group; hydroxy(C₁-C₆ alkyl) group;, protected hydroxy (C₁-C₆ alkyl) group; [C₅-C₆ cycloalkyl]-(C₁-C₆ alkyl) group; and heterocyclyl(C₁-C₆ alkyl) group, in which the heterocyclic portion is a 3- to 8-membered unsaturated heteromonocyclic group containing 1 to 4 nitrogen atoms, a 3- to 8-membered unsaturated heteromonocyclic group containing 1 to 2 oxygen atoms and 1 to 3 nitrogen atoms, or a 3- to 8-membered unsaturated heteromonocyclic group containing 1 to 2 sulphur atoms and 1 to 3 nitrogen atoms;

[0449] l₃₉, m₃₉ and n₃₉ are each identical or different and equal to the integer 0 or 1 provided that:

[0450] (i) when l₃₉ is an integer 0,

[0451] A₃₉ ² is then not a group of formula

—NHCH₂CH₂CO—

[0452] and

[0453] (ii) when l₃₉ and m₃₉ are each the integer 0,

[0454] R₃₉ ¹ is a phenyl group having an amidino or naphthyl substituent having an amidino substituent

[0455] R₃₉ ² is a carboxymethyl or (C₁-C₆ alkoxy)carbonylmethyl group

[0456] R₃₉ ³ is a carboxyl group or a (C₁-₆ alkoxy)carbonyl group,

[0457] R₃₉ ⁴ is a (C₁-C₄)alkyl group and

[0458] A₃₉ ¹ is a (C₁-C₆)alkylene group,

[0459] A₃₉ ³ is then a (C₁-C₆)alkylene group which has a substituent selected from the group, consisting of the groups: propyl, butyl, phenyl(C₁-C₆ alkyl) having a methoxy or ethoxy substituent; hydroxy (C₁-C₆ alkyl); and [C₅-C₆ cycloalkyl]-(C₁-C₆ alkyl);

[0460] (iii) when l₃₉ is an integer 1,

[0461] m₃₉ and n₃₉ are each the integer 0,

[0462] R₃₉ ¹ is a 6-amidino-2-naphthyl group,

[0463] R₃₉ ² is a carboxymethyl group

[0464] R₃₉ ⁵ is a carboxyl group

[0465] A₃₉ ¹ is a methylene group,

[0466] A₃₉ ³ is then not a methylene group having a benzyl substituent,

[0467] or one of its pharmaceutically acceptable salts, as described in EP 513675.

[0468] XXXX—Orbofiban or One of its Lactam Analogues of Formula:

[0469] in which

[0470] R₄₀ is a protecting group selected from the group consisting of t-butoxycarbonyl and carbobenzyloxy;

[0471] Z₄₀ is selected from the group consisting of —CN, —CONH₂ and CO₂ alkyl, as described in U.S. Pat. No. 5,484,946.

[0472] XXXXI—Alprostadil or its Analogues of Formula:

[0473] in which:

[0474] X₄₁ and Z₄₁ are —CH₂CH₂— and

[0475] Y₄₁ is —CH₂—CH₂— or —C═CH—, or in which:

[0476] X₄₁ and Y₄₁ are —CH═CH—, and

[0477] Z₄₁ is —CH₂—CH₂— or —CH—CH—

[0478] and its pharmaceutically acceptable salts, as described in GB 1,040,544.

[0479] XXXXII—Epoprostenol and its Analogues of Formula:

[0480] in which:

[0481] R₄₂ represents a hydrogen or a pharmacologically acceptable cation,

[0482] and

[0483] Z₄₂ ¹ and Z₄₂ ² are a hydrogen and/or a protecting group, as described in DE 2,720,999.

[0484] XXXXIII—Iloprost and its Analogues of Formula;

[0485] or one of its derivatives described in Ger. pat. 2,845,770 and U.S. Pat. No. 4,692,464.

[0486] XXXXIV—Beraprost or One of its Analogues of Formula:

[0487] in which:

[0488] R¹ ₄₄ is a pharmaceutically acceptable cation, a hydrogen atom or an n-alkyl group having from 1 to 12 carbon atoms;

[0489] R² ₄₄ is a hydrogen atom, an acyl group having 2 to 10 hydrocarbon atoms, or an aroyl group of 7 to 13 carbon atoms;

[0490] R³ ₄₄ is a hydrogen atom, an acyl group of 2 to 10 carbon atoms or an aroyl group of 7 to 13 carbon atoms;

[0491] in which:

[0492] the carbon atom carrying R² ₄₆ may be racemic or of S configuration;

[0493] R¹ ₄₆ is hydrogen, a pharmaceutically acceptable cation or the residue of an alcohol which may be pharmaceutically used in an esterified form;

[0494] R² ₄₆ is hydrogen or CH₂;

[0495] A₄₆ is trans-vinylene or a 1,2-ethylene; and

[0496] B₄₆ is the (C₅-C₉) residue of structure —C(R³ ₄₆) (R⁴ ₄₆)—(CH₂)₃—CH₃ in which R³ ₄₆ and R⁴46 are each hydrogen, CH₃ or C₂H₅; or B₄₆ represents a cyclohexyl optionally substituted at the 4-position with CH₃ or a C₂H₅, as described in EP 45842.

[0497] XXXXVII—Ataprost or One of its Derivatives of Formula:

[0498] in which:

[0499] R₄₇ ¹ represents a hydrogen, atom or a lower alkyl group,

[0500] R₄₇ ² represents a 2-methylhexyl group, a 3-propylcyclopentyl, 3-butylcyclopentyl, or a 4-propylcyclohexyl group; as defined in DE 3,316,356.

[0501] XXXXVIII—Ciprostene or a Carbacycline Analogue of Formula:

[0502] in which:

[0503] n₄₈ is one or two;

[0504] L¹ ₄₈ is α-R³ ₄₈, β-R⁴ ₄₈: α-R³ ₄₈, or a mixture of α-R³ ₄₈:β-R⁴ ₄₈ and of α-R⁴ ₄₈:β-R³ ₄₈

[0505] in which:

[0506] R³ ₄₈ and R⁴ ₄₈ which are identical or different, are a hydrogen, a methyl or a fluorine, with the proviso that R³ ₄₈ or R⁴ ₄₈ is solely a fluorine if the other is a hydrogen or a fluorine;

[0507] M¹ ₄₈ is an α-OH:β-R⁵ ₄₈ or, α-R⁵ ₄₈:β-OH

[0508] R⁵ ₄₈ is a hydrogen or a methyl;

[0509] R⁷ ₄₈ is:

[0510] (1) —C_(m48)H_(2m48)—CH₃, in which m₄₈ is an integer from 1 to 5,

[0511] (2) a phenoxy optionally substituted with one, two or three fluorine, chlorine or trifluoroethyl, a (C₁-C₃)alkyl, or a (C₁-C₃)alkoxy, with the proviso that R⁷ ₄₈ is a phenoxy or a substituted phenoxy only when R₄₈ ³ and R₄₈ ⁴, which are identical or different, are a hydrogen or a methyl,

[0512] (3) a phenyl, a, benzyl, a phenylethyl, or a phenylpropyl optionally substituted on the aromatic ring with one, two or three chlorine, fluorine, or trifluoromethyl, a (C₁-C₃)alkyl, a (C₁-C₃)alkoxy, with the proviso that at most two substituents are different from an alkyl;

[0513] (4) cis-CH═CH—CH₂—CH₃,

[0514] (5) —(CH₂)₂—CH(OH)CH₃, or

[0515] (6) —(CH₂)₃—CH═C(CH₃)₂;

[0516] —C(L¹ ₄₈)R⁷ ₄₈ together represents;

[0517] (1) a (C₄-C₇)cycloalkyl optionally substituted with one to three (C₁-C₅)alkyl;

[0518] (2) a 2-(2-furyl)ethyl;

[0519] (3) a 2-(3-thienyl)ethoxy, or

[0520] (4) a 3-thienyloxymethyl;

[0521] R₄₈ ⁸ is a hydroxyl, a hydroxymethyl or a hydrogen;

[0522] R₄₈ ¹⁶ is hydrogen or a fluorine;

[0523] R₄₈ ¹⁶ is a hydrogen or R₄₈ ¹⁶ and R₄₈ ¹⁷ together form a —CH₂—;

[0524] R₄₈ ¹⁷ is defined as above or is

[0525] (1) a hydrogen,

[0526] (2) a (C₁-C₄)alkyl;

[0527] (1) R²⁰ ₄₈, R²¹ ₄₈, R²² ₄₈, R²³ ₄₈ and R²⁴ ₄₈ are all hydrogens with R²² ₄₈ representing an α-hydrogen or a β-hydrogen, or

[0528] (2) R²⁰ ₄₈ is a hydrogen, R²¹ ₄₈ and R²² ₄₈ together form a second bond with a valency between C-9 and C-6a and R²³ ₄₈ and R²⁴ ₄₈ together form a second bond with a valency between C-8 and C-9 or are both hydrogens, or

[0529] (3) R²² ₄₈, R²³ ₄₈ and R²⁴ ₄₈ are all hydrogen, with R²² ₄₈ being either an α-hydrogen or a β-hydrogen and

[0530] (a) R²⁰ ₄₈ and R²¹ ₄₈ together are an oxo or

[0531] (b) R²⁰ ₄₈ is a hydrogen and R²¹ ₄₈ is a hydroxyl, or an α-hydroxyl or a β-hydroxyl;

[0532] X¹ ₄₈ is

[0533] (1) a —COOR¹ ₄₈ in which:

[0534] R¹ ₄₈ is

[0535] (a) a hydrogen

[0536] (b) a (C₁-C₁₂)alkyl,

[0537] (c) a (C₃-C₁₀)cycloalkyl,

[0538] (d) a (C₇-C₁₂) aralkyl,

[0539] (e) a phenyl optionally substituted with one, two or three chlorine or a (C₁-C₃)alkyl,

[0540] (f) a phenyl substituted on the para position with an —NH—CO—R²⁵ ₄₈, a —CO—R²⁶ ₄₈, an —O—CO—R²⁴ ₄₈ or a —CH═N—NH—CO—NH₂ in which R²⁵ ₄₈ is a methyl, a phenyl, an acetamidophenyl, a benzamidophenyl or amino; R²⁶ ₄₈ is a methyl or phenyl, —NH₂ or methoxy; and R²⁴ ₄₈ is a phenyl or an acetamidophenyl, or

[0541] (g) a pharmaceutically/pharmacologically acceptable cation;

[0542] (2) a —CH₂OH,

[0543] (3) a —COL⁴ ₄₈, in which:

[0544] L⁴ ₄₈ is

[0545] (a) an amino of formula —NR²¹ ₄₈R²² ₄₈, in which R²¹ ₄₈ and R²² ₄₈ are a hydrogen, a (C₁-C₁₂)alkyl; a (C₃-C₁₀) cycloalkyl; a (C₇-C₁₂)aralkyl; a phenyl optionally substituted with one, two or three chlorine, with (C₁-C₃)alkyl, with a hydroxyl, with a carboxyl, with a (C₂-C₅)alkoxycarbonyl, or with a nitro, a (C₂-C₅)carboxyalkyl; a (C₂-C₅)carbamoylalkyl; a (C₂-C₅)cyanoalkyl, a (C₃-C₆)acetylalkyl; a (C₇-C₁₁)benzoalkyl optionally substituted with one, two or three chlorine, (C₁-C₃)alkyl, hydroxyl, (C₁-C₃)alkoxy, carboxyl, (C₂-C₅)alkoxycarbonyl or nitro; a pyridyl optionally substituted with one, two or three chlorine, (C₁-C₃)alkyl or (C₁-C₃)alkoxy; a (C₅-C₉)pyridylalkyl optionally substituted with one, two or three chlorine, (C₁-C₃)alkyl, hydroxyl, or (C₁-C₃)alkyl; a (C₁-C₄)hydroxyalkyl; a (C₁-C₄)dihydroxyalkyl, a (C₁-C₄)trihydroxyalkyl;

[0546] with the additional limitation that only one radical from R²¹ ₄₈ and R²² ₄₈ is distinct from a hydrogen or an alkyl,

[0547] (b) a cyclic amine selected from the group consisting of pyrrolidinol piperidino, morpholino, piperazino, hexamethylenimino, pyrrolino, or 3,4-didehydro-piperidinyl optionally substituted with one or two (C₁-C₁₂) alkyl,

[0548] (c) a carbonylamino of formula —NR²³ ₄₈COR²¹ ₄₈, in which R²³ ₄₈ is a hydrogen, or a (C₁-C₄) alkyl and R²¹ ₄₈ is other than a hydrogen, and otherwise defined as above,

[0549] (d) a sulphonylamino of formula —NR²³ ₄₈SO₂R²¹ ₄₈, in which R²¹ ₄₈ and R²³ ₄₈ are as defined for (c)

[0550] (4) a —CH2NL² ₄₈L³ ₄₈ in which L² ₄₈ and L³ ₄₈, which are identical or different, are hydrogen, or a (C₁-C₄)alkyl,

[0551] or one of its pharmaceutically acceptable acid addition salts when X¹ ₄₈ is —CH₂NL² ₄₈L³ ₄₈,

[0552] Y¹ ₄₈ is trans-CH═CH—, cis-CH═CH—, —CH₂CH₂—, or —C≡C—;

[0553] Z¹ ₄₈ is

[0554] (1) a —CH₂—(CH₂)_(f48)—C(R² ₄₈)₂, in which:

[0555] R² ₄₈ is a hydrogen, or a fluorine and f₄₈ is 0, 1, 2 or 3

[0556] (2) a trans-CH₂—CH═CH—

[0557] (3) —(Ph)(CH₂)_(g48)— in which (Ph) is 1,2-, 1,3-, 1,4-phenylene, and g₄₈ is 0, 1, 2 or 3; with the proviso that

[0558] (1) R¹⁵ ₄₈, R¹⁶ ₄₈, R¹⁷ ₄₈ are all hydrogens when -Z¹ ₄₈ is —(Ph)(CH₂)_(g48)—

[0559] and

[0560] (2) Z¹ ₄₈ is (Ph)—(CH₂)_(g48)— only if R¹⁵ ₄₈ is a hydrogen, as defined in GB 2,070,596.

[0561] XXXXIX—Dipyramidole or its Analogues Selected From the Group Consisting of Substituted Basic Dipyrimido-[5,4-d]pyrimides of Formula:

[0562] in which from 2 to 4 of the substituents R₄₉ ¹, R₄₉ ², R₄₉ ³, R₄₉ ⁴ are basic entities selected from the group consisting of an amino, a lower alkylamino, a dialkylamino in which the alkyl entity has from 1 to 12 carbon atoms, a monohydroxy(lower alkyl)amino, a di-(lower hydroxyalkyl)alkylamino in which the alkyl entity has from 1 to 12 carbon atoms, a (lower alkoxy-lower alkyl)amino, a (lower alkenyl)amino, a cyclohexylamino, a phenylamino, a halophenylamino, a nitrophenylamino, a (lower alkoxyphenyl)amino, a ((lower dialkylamino)phenyl]amino, a benzylamino, a semicarbazidyl, a hydrazinyl, a guanidyl, an ethylenimino, a piperidyl, a lower alkylpiperidyl, a lower alkoxypiperidyl, a hydroxypiperidyl, a pyrrolidyl, a lower alkylpyrrolidyl, a lower alkoxypyrrolidyl, a hydroxypyrrolidyl, a morpholyl, a lower alkylmorpholyl, a lower alkoxymorpholyl, a hydroxymorpholyl, a tetrahydropyridyl, a lower alkyltetrahydropyridyl, a lower alkoxytetrahydropyridyl, a hydroxytetrahydropyridyl, a hexamethylenimino, a lower alkylhexamethylenimino, a lower alkoxyhexamethylenimino, a hydroxyhexamethylenimino, a tetrahydroquinolyl, a lower alkyltetrahydroquinolyl, a lower alkoxytetrahydroquinolyl, a hydroxytetrahydroquinolyl, a piperazyl, a lower alkylpiperazyl, a lower alkoxypiperazyl, a hydroxypiperazyl, and a lower N′-alkylpiperazyl, and the substituents remaining R₄₉ ¹ to R₄₉ ⁴ are selected from the group consisting of hydrogen, halogen, hydroxyl, mercapto, lower alkyl, phenyl, lower alkoxy, lower dialkylamino(lower alkoxy), and a lower alkylthio, a phenylthio, a benzylthio, a lower alkoxyalkoxy, their nontoxic alkali metal salts and their nontoxic addition salts with an acid, as described in U.S. Pat. No. 3,031,450.

[0563] L—Cilostazol or One of its Analogues of Formula:

[0564] in which:

[0565] R₅₀ ¹ represents a hydrogen atom, a lower alkyl group, a lower alkenyl group, a lower alkanoyl group, a benzoyl group or a phenylalkyl group;

[0566] R₅₀ ² represents a hydrogen atom, a lower alkyl group or a group of formula:

[0567] R₅₀ ³ represents a lower alkyl group, a cycloalkyl group, a cycloalkylalkyl group, a phenyl group or a phenylalkyl group;

[0568] A₅₀ represents a lower alkylene group;

[0569] the carbon-carbon bond between the 3- and 4-positions of the carbostyrile backbone is a single bond or a double bond;

[0570] and the position of the group corresponding to the formula:

[0571] on the carbostyrile backbone is the 4-, 5-, 6-, 7- or 8-position with the proviso that a single group of formula above can be attached to the entire carbostyrile backbone,

[0572] thus, when R₅₀ ² at the 4-position represents

[0573] the 5-, 6-, 7- or 8-positions do not have such a group, it being possible for the phenyl group of the abovementioned benzoyl, phenylalkyl or phenyl groups to have one or more substituents, as described in BE 878 548.

[0574] The preferred antiplatelet aggregating agents are aspirin, ticlopidine, clopidogrel or antagonists of glycoprotein IIb/IIIa. It will be noted, however, that the use of aspirin is not recommended in patients having undergone a revascularization procedure such as a percutaneous angioplasty. The preferred glycoprotein IIb/IIIa antagonists are:

[0575] ethyl N-(1-ethoxycarbonylmethylpiperidin-4-yl)-N-{4-[4-{(N-ethoxycarbonylimino) (amino)methylphenyl]-thiazol-2-yl}-3-aminopropionate, designated SR 121787A, and its pharmaceutically acceptable salts, and

[0576] N-(1-carboxymethylpiperidin-4-yl)-N-{4-[4-{(amino)-(imino)methyl}phenyl]thiazol-2-yl}-3-aminopropionic acid,

[0577] and its pharmaceutically acceptable salts, such as the trihydrochloride, designated SR 121566.

[0578] The formulae of SR 121787 and of SR\ 121566 are recalled below:

[0579] The selective inhibitor of factor Xa, alone or in combination with an anti-platelet aggregation agent, is particularly useful for the treatment or prophylaxis of pathological conditions such as disorders of the cardiovascular or cerebrovascular system such as thromboembolic disorders associated with atherosclerosis or with diabetes such as unstable angina, cerebral attack, restenosis following angioplasty, endarterectomy or fitting of metallic endovascular prostheses, or such as thromboembolic disorders associated with rethrombosis following thrombolysis, with infarction, with dementia of ischaemic origin, with peripheral arterial diseases, with haemodialysis, with atrial fibrillations, or during the use of vascular prostheses, of aortocoronary bypasses or for stable or unstable angina, or for patients treated by a revascularization procedure at the risk of thrombosis including percutaneous angioplasties, endovascular prostheses, vascular prostheses, aortocoronary bypasses.

[0580] As examples of pharmaceutically acceptable organic salts, there may be mentioned oxalate, maleate, fumarate, methanesulphonate, benzoate, ascorbate, pamoate, succinate, hexamate, bismethylenesalicylate, ethanedisulphonate, acetate, propionate, tartrate, salicylate, citrate, gluconate, lactate, malate, cinnamate, mandelate, citraconate, aspargate, palmitate, stearate, itaconate, glycolate, p-aminobenzoate, glutamate, benzenesulphonate and theophylline acetate as well as the salts formed from an amino acid such as the lysine or histidine salt.

[0581] As examples of pharmaceutically acceptable inorganic salts, there may be mentioned hydrochloride, hydrobromide, sulphate, sulphamate, phosphate and nitrate.

[0582] The neutralization of activated factor X (Xa) (by antithrombin III) can be catalysed by the pentasaccharide (PS) such as low-molecular-weight heparin. Unlike the low-molecular weight heparin, the pentasaccharide is completely devoid of activated thrombin. In addition, the penta-saccharide hardly modifies the haemostasis tests and in particular the activated partial thromboplastin time (APTT) test on human plasma and unlike heparin, it does not potentiate ADP or platelet aggregation induced by collagen.

[0583] However, the antithrombotic effects of the pentasaccharide have been demonstrated after intravenous (i.v.) and subcutaneous (S.C.) administration in different animal models with different types of induced thromboses (the venous stasis model in rats, the arteriovenous shunt model in rats, the Wessler model in rabbits) (Hobellen P M J et al, Tromb. & Haemost., 1996, 63(2), 265-270 and Amar J. et al, Br. J. Haematol., 1990, 76, 94-100). As regards the risk of bleeding, the loss of blood at high PS dose tested in rats (21.7 mg/kg) is identical to that observed with 200 units anti-Xa/kg of heparin, thus indicating that PS only slightly increases blood loss compared with standard heparin or LMWHs.

[0584] To illustrate the invention and by way of example, there will be given below the results obtained during the study of the potentiation of the antithrombotic effect in rabbits by co-administration of a selective inhibitor of factor Xa and of an anti-platelet aggregation agent. As selective inhibitor of factor Xa, SR 90107/ORG 31540 (or PS) was selected and the anti-platelet aggregation agent was selected from the antagonists of glycoprotein IIb/IIIa, namely SR 121787A.

[0585] The aim of this test was therefore to determine the arterial antithrombotic effects of the co-administration of an anti-Xa, the pentasaccharide SR 90107/ORG 31540. and of an antagonist of the GPIIb/IIIa receptors, SR 121787A.

[0586] New Zealand male rabbits weighing 2.7 to 3 kg, obtained from the Lago breeding unit (France) were used. They were housed under standard conditions.

[0587] The formation of the thrombus was induced by external electrical stimulation of the left common carotid according to the Hladovec I. et al. method (Experimental arterial thrombosis in rats with continuous registration, Throm. Diathes. Haemor. 1971; 26: 407-410). The rabbits were anaesthetized with pentobarbital at the dose of 30 mg/kg iv. A segment of the left carotid artery was exposed and insulated by a piece of insulating film. Electrodes were inserted under the artery. A partial stricture inducing a 20% reduction in flow rate was made in the artery. The latter was then stimulated with the aid of a 2.5 mA current delivered by a constant current stimulator for 3 minutes. The thrombotic occlusion was evaluated by continuous measurement of the flow rate of blood in the carotid by means of an NARCO electromagnetic flow meter. This measurement was made over an observation period of 45 minutes.

[0588] For the treatment, solutions of SR 90107/ORG 31540 and of SR 121787A were prepared immediately before use in a saline solution. The solutions of SR 90107/QRG 31540 were injected by the IV route 5 minutes before induction of thrombosis in a volume of 1 ml/kg. SR 121787A was administered by the oral route 2 hours earlier.

[0589] The results were calculated and expressed as % reduction in blood flow rate at various times relative to time 0.They are grouped together in FIG. 1.

[0590] In the control animals, the flow rate was gradually reduced from 20.9±2.1 to 3.8±2.5 ml/min (n=8: mean for 8 animals) over 15 minutes and 1.5±1.4 ml/min over 20 min. It then stayed at this level for up to 45 minutes. SR 90107/ORG 31540, at the dose of 300 nmol/kg, had no influence on this reduction in flow,rate. 600 nmol/kg of SR 90107/ORG 31540 reduced it slightly but not significantly.

[0591] SR 121787A administered 2 hours before as sole active ingredient at the oral dose of 10 mg/kg, did not significantly modify the course of the carotid output whereas 20 mg/kg almost completely inhibited the drop in the latter.

[0592] The co-administration of the pentasaccharide SR 90107/ORG 31540 and of the antagonist of the GPIIb/IIIa receptor SR 121787A, at doses which are separately inactive (300 nmol/kg iv and 10 mg/kg po, respectively), completely protected against reduction in flow rate and therefore against the arterial thrombosis thus induced.

[0593] No toxicological effect of SR 90107/ORG 31540 was observed on any animal species whatsoever, regardless of the concentration tested in the appropriate toxicity studies and by repeated assays (over a period of 4 weeks with up to 10 mg/kg subcutaneously). SR 90107/ORG 31540 is not mutagenic in the AMES test, or in the DNA repair test.

[0594] Thus, the use of a direct selective inhibitor of factor Xa, such as DX-9065a or of an indirect selective inhibitor of factor Xa, such as an oligosaccharide, alone or in combination with an anti-platelet aggregation agent, is particularly beneficial for pathological conditions such as disorders of the cardiovascular and cerebrovascular system such as thromboembolic disorders associated with atherosclerosis or with diabetes such as unstable angina, cerebral attack, restenosis following angioplasty, endarterectomy or fitting of metallic endovascular prostheses or such as thromboembolic disorders associated with rethrombosis following thrombolysis, with infarction, with dementia of ischaemic origin, with peripheral arterial diseases, with haemodialysis, with atrial fibrillations or during the use of vascular prostheses or of aortocoronary bypasses, or for stable or unstable angina, or for patients treated by a revascularization procedure at risk of thrombosis including percutaneous angioplasties, endovascular prostheses, vascular prostheses, aortocoronary bypasses.

[0595] In addition, the use of a direct selective inhibitor of factor Xa, such as DX-9065a or of an indirect selective inhibitor of factor Xa, such as an oligosaccharide, alone or in combination with the anti-platelet aggregation agents, does not increase the haemorrhagic risk.

[0596] The combination of a direct selective inhibitor of factor Xa, such as DX-9065a or of an indirect selective inhibitor of factor Xa, such as an oligosaccharide and of the anti-platelet aggregation agent may be formulated in pharmaceutical compositions which can be used by the oral or parenteral route, in particular by the subcutaneous route, in the form of a mixture with conventional pharmaceutical excipients.

[0597] Thus, according to another of its features, the invention relates to the pharmaceutical compositions comprising one or more direct or indirect selective inhibitors of factor Xa acting via antithrombin III in combination with one or more compounds with anti-platelet aggregation activity, and optionally one or more pharmaceutically acceptable vehicles.

[0598] The preferred pharmaceutical compositions of the invention comprise an antagonist of glycoprotein IIb/IIIa as anti-platelet aggregation agent and methyl O-(2-deoxy-2-sulphoamino-6-O-sulfo-α-D-glucopyranosyl)-(1→4)-O-(β-D-glucopyranosyluronic acid-(1→4)-O-(2-deoxy-2-sulphoamino-3,6-di-O-sulpho-α-D-glucopyranosyl-(1→4)-O-(2-O-sulpho-α-L-idopyranosyluronic acid)-(1→4)-2-deoxy-2-sulphoamino-6-O-sulpho-α-D-gluco-pyranoside whose anion has the structure (B)

[0599] or one of its pharmaceutically acceptable salts, as indirect selective inhibitor of factor Xa.

[0600] Another preferred group of pharmaceutical compositions consists of the compositions comprising methyl O-(2-deoxy-2-sulphoamino-6-O-sulfo-α-D-gluco-pyranosyl)-(1→4)-O-(β-D-glucopyranosyluronic acid-(1→4)-O-(2-deoxy-2-sulphoamino-3,6-di-O-sulpho-α-D-glucopyranosyl-(1→4)-O-(2-O-sulpho-α-L-idopyranosyl-uronic acid)-(1→4)-2-deoxy-2-sulphoamino-6-O-sulpho-α-D-glucopyranoside whose anion has the structure (B)

[0601] or one of its pharmaceutically acceptable salts, as indirect selective inhibitor of factor Xa, and aspirin, as anti-platelet aggregation agent.

[0602] The pharmaceutical compositions which are the subject of the present invention are preferably provided in the form of dosage units containing a predetermined quantity of the active ingredients, as specified below. The unit forms forms administration by the oral route comprise tablets, gelatin capsules, powders, granules, microgranules.

[0603] The antiplatelet aggregation agent may be formulated according to methods well known to persons skilled in the art. The same applies to the selective inhibitor of factor Xa.

[0604] In the formulation of the combinations of active ingredients for the preparation of the pharmaceutical compositions according to the present invention, the nature of the active ingredients entering into the combination will be taken into account.

[0605] Thus, when the selective inhibitor of factor Xa is an oligosaccharide, the latter is preferably used in the form of an addition salt in the composition, for example in the form of a sodium salt.

[0606] Normally, the oligosaccharides in the form of their addition salts with pharmaceutically acceptable acids are not chemically incompatible with the nonsalified anti-platelet aggregation agents. However, some of the latter are also used in the form of acid addition salts. In any case, it is preferable to keep the active ingredients separate according to techniques well known in the literature.

[0607] The pharmaceutical compositions of the present invention are particularly suitable in the treatment or prophylaxis of pathological conditions such as disorders of the cardiovascular and cerebrovascular system such as thromboembolic disorders associated with atherosclerosis or with diabetes such as unstable angina, cerebral attack, restenosis following angioplasty, endarterectomy or fitting of metallic endovascular prostheses, or such as thromboembolic disorders associated with rethrombosis following thrombolysis, with infarction, with dementia of ischaemic origin, with peripheral arterial diseases, with haemodialysis, with atrial fibrillations, or during the use of vascular prostheses, of aortocoronary bypasses or for stable or unstable angina, or for patients treated by a revascularization, procedure at risk of thrombosis including percutaneous angioplasties, endovascular prostheses, vascular prostheses and aortocoronary bypasses.

[0608] The combinations according to the invention may be formulated in pharmaceutical compositions for administration to mammals, including humans, for the treatment of the abovementioned diseases.

[0609] The combinations according to the invention may be used at daily doses of the selective inhibitor of factor Xa or of the anti-platelet aggregation agent of 0.1 to 100 mg per kilo of body weight of the mammal to be treated.

[0610] In human beings, the dose may vary for each of the components from 1 to 500 mg per day, according to the age of the subject to be treated and the type of treatment: prophylactic or curative. Preferably, the pentasaccharide is administered at doses of between 0.30 mg and 30 mg per patient and per day.

[0611] In the pharmaceutical compositions of the present invention, the active ingredients are generally formulated in dosage units containing from 0.1 to 50 mg of the said active ingredient per dosage unit.

[0612] The compositions of the invention are prepared so as to be able to be administered by the digestive or parenteral route and are provided in various forms, such as for example of injectable or oral solutions, sugar-coated tablets, plain tablets or gelatin capsules. The injectable solutions are the preferred pharmaceutical forms.

[0613] In the pharmaceutical compositions of the present invention for oral, sublingual, subcutaneous, intramuscular, intravenous, transdermal, transmucosa, local or rectal administration, the active ingredient may be administered in unit forms for administration, in the form of a mixture with conventional pharmaceutical carriers, to animals and to human beings. The appropriate unit forms for administration comprise the forms to be administered by the oral route, such as tablets, gelatin capsules, powders, granules and oral solutions or suspensions, the forms for sublingual or buccal administration, the forms for subcutaneous, intramuscular, intravenous, intranasal or intraocular administration and the forms for rectal administration.

[0614] When a solid composition in the form of tablets is prepared, the principal active ingredient is mixed with a pharmaceutical vehicle such as gelatin, starch, lactose, magnesium stearate, talc, gum arabic and the like. The tablets may be coated with sucrose or other appropriate materials or they may be treated such that they have a prolonged or delayed activity and that they continuously release a predetermined quantity of active ingredient.

[0615] A preparation of gelatin capsules is obtained by mixing the active ingredient with a diluent and by pouring the mixture obtained into soft or hard gelatin capsules.

[0616] The water-dispersible powders or granules may contain the active ingredient in the form of a mixture with dispersing agents or wetting agents, or suspending agents, such as polyvinylpyrrolidone, as well as with sweeteners or with flavour correctors.

[0617] For a rectal administration, suppositories are used which are prepared with binding agents which melt at the rectal temperature, for example cocoa butter or polyethylene glycols.

[0618] For a parenteral, intranasal or intraocular administration, aqueous suspensions, isotonic saline solutions or sterile and injectable solutions are used which contain pharmacologically compatible dispersing agents and/or wetting agents, for example propylene glycol or butylene glycol.

[0619] For transmucosa administration, the active ingredients may be formulated in the presence of a promoter such as a bile salt, a hydrophilic polymer such as for example hydropropylcellulose, hydroxypropylmethylcellulose, hydroxyethylcellulose, ethyl cellulose, carboxymethylcellulose, dextran, polyvinylpyrrolidone, pectins, starches, gelatin, casein, acrylic acids, acrylic esters and their copolymers, vinyl polymers or copolymers, vinyl alcohols, alkoxy polymers, polyethylene oxide polymers, polyethers or their mixture.

[0620] The active ingredients may also be formulated in the form of microcapsules, optionally with one or more carriers or additives.

[0621] The active ingredients may also be provided in the form of a complex with a cyclodextrin, for example α-, β- or γ-cyclodextrin, 2-hydroxypropyl-β-cyclodextrin or methyl-β-cyclodextrin.

[0622] One of the active ingredients, for example the oligosaccharide, inhibitor of factor Xa, may also be released by a balloon containing it and by an endovascular expander introduced into the blood vessels. The pharmacological efficacy of the active ingredient is thus not affected.

[0623] Preferably, the selective inhibitor of factor Xa is administered by the intravenous or subcutaneous route.

[0624] In the therapeutic combinations according to the present invention, the pharmaceutical forms preferably contain 8 to 30 mg of selective inhibitor of factor Xa and 10 to 200 mg of anti-platelet aggregation compound.

[0625] The combination of 15 to 25 mg of selective inhibitor of factor Xa and of 10 to 30 mg of anti-platelet aggregation agent is particularly advantageous. Better still, the pharmaceutical forms of the present invention comprise 20 mg of a pentasaccharide, selective inhibitor of factor Xa, and 20 mg of an anti-platelet aggregation agent. 

1. Use of direct or indirect selective inhibitors of factor Xa which act via antithrombin III, alone or in combination with one or more compounds with anti-platelet aggregation activity, for the preparation of medicines intended to prevent and to treat thromboembolic arterial diseases.
 2. Use according to claim 1, of a direct or indirect selective inhibitor of factor Xa which acts via antithrombin III, alone or in combination with a compound with anti-platelet aggregation activity.
 3. Use according to either of claims 1 and 2, characterized in that there is used as direct selective inhibitor of factor Xa (2S)-2-[4-[[(3S)-1-acetimidoyl-3-pyrrolidinyl]oxy]phenyl]-3-(7-amidino-2-naphthyl)-propanoic acid of structure (A)

or one of its pharmaceutically acceptable salts.
 4. Use according to either of claims 1 and 2, characterized in that an oligosaccharide is used as indirect inhibitor of factor Xa.
 5. Use according to claim 4, characterized in that the indirect inhibitor of factor Xa is methyl O-(2-deoxy-2-sulphoamino-6-O-sulfo-α-D-glucopyranosyl)-(1→4)-O-(β-D-glucopyranosyluronic acid)-(1→4)-O-(2-deoxy-2-sulphoamino-3,6-di-O-sulpho-α-D-glucopyranosyl-(1→4)-O-(2-O-sulpho-α-L-idopyranosyluronic acid)-(1→4)-2-deoxy-2-sulphoamino-6-O-sulpho-α-D-gluco-pyranoside whose anion has the structure (B)

or one of its pharmaceutically acceptable salts.
 6. Use according to any one of the preceding claims, for the preparation of medicines intended to prevent and to treat arterial thromboembolic diseases in patients not treated by a revascularization procedure, such as percutaneous angioplasty, characterized in that aspirin is used as anti-platelet aggregation agent.
 7. Use according to one of claims 1 to 5, characterized in that ticlopidine or clopidogrel is used as anti-platelet aggregation agent.
 8. Use according to any one of claims 1 to 5, characterized in that an antagonist of glycoprotein IIb/IIIa is used as anti-platelet aggregation agent.
 9. Use according to claim 8, characterized in that the antagonist of glycoprotein IIb/IlIa is selected from ethyl N-(1-ethoxycarbonylmethylpiperidin-4-yl)-N-{4-(4-{(N-ethoxycarbonylimino)(amino)methyl}phenyl]-thiazol-2-yl}-3-aminopropionate, N-(1-carboxymethylpiperidin-4-yl)-N-{4-[4-{(amino)-(imino)methyl}phenyl]thiazol-2-yl}-3-aminopropionic acid, and their pharmaceutically acceptable salts.
 10. Use according to claim 9, characterized in that the antagonist of glycoprotein IIb/IIIa is ethyl N-(1-ethoxycarbonylmethylpiperidin-4-yl)-N-(4-[4-{(N-ethoxycarbonylimino)(amino)methyl}phenyl]thiazol-2-yl)-3-aminopropionate or N-(1-carboxymethylpiperidin-4-yl)-N-{4-[4-{(amino)(imino)methyl}phenyl]thiazol-2-yl}-3-aminopropionic acid trihydrochloride.
 11. Pharmaceutical compositions containing one or more direct or indirect selective inhibitors of factor Xa acting via antithrombin III in combination with one or more compounds with anti-platelet aggregation activity, and optionally one or more pharmaceutically acceptable vehicles.
 12. Pharmaceutical compositions according to claim 11, comprising an antagonist of glycoprotein IIb/IIIa as anti-platelet aggregation agent and methyl O-(2-deoxy-2-sulphoamino-6-O-sulfo-α-D-glucopyranosyl)-(1→4)-O-(β-D-glucopyranosyluronic acid-(1→4)-O-(2-deoxy-2-sulphoamino-3,6-di-O-sulpho-α-D-glucopyranosyl-(1→4)-O-(2-O-sulpho-α-L-idopyranosyluronic acid)-(1→4)-2-deoxy-2-sulphoamino-6-O-sulpho-α-D-glucopyranoside whose anion has the structure (B)

or one of its pharmaceutically acceptable salts, as indirect selective inhibitor of factor Xa.
 13. Pharmacological compositions according to claim 11, comprising methyl O-(2-deoxy-2-sulphoamino-6-O-sulfo-α-D-glucopyranosyl)-(1→4)-O-(β-D-gluco-pyranosyluronic acid)-(1→4)-O-(2-deoxy-2-sulphoamino-3,6-di-O-sulpho-α-D-glucopyranosyl-(1→4)-O-(2-O-sulpho-α-L-idopyranosyluronic acid)-(1→4)-2-deoxy-2-sulphoamino-6-O-sulpho-α-D-glucopyranoside whose anion has the structure (B)

or one of its pharmaceutically acceptable salts, as indirect selective inhibitor of factor Xa, as anti-platelet aggregation agent.
 14. Use according to claim 1, the said mediaments being active for pathological conditions such as disorders of the cardiovascular or cerebrovascular system such as thromboembolic disorders associated with atherosclerosis or with diabetes such as unstable angina, cerebral attack, restenosis following angioplasty, endarterectomy or fitting of metallic endovascular prostheses, or such as thromboembolic disorders associated with rethrombosis following thrombolysis, with infarction, with dementia of ischaemic origin, with peripheral arterial diseases, with haemodialysis, with atrial fibrillations, or during the use of vascular prostheses, of aortocoronary bypasses or for stable or unstable angina, or for patients treated by a revascularization procedure at the risk of thrombosis including percutaneous angioplasties, endovascular prostheses, vascular prostheses, aortocoronary bypasses. 